Effects of Pre- and Post-Exercise Cold-Water Immersion Therapy on Passive Muscle Stiffness - Hüttel, Moritz; Golditz, Tobias; Mayer, Isabel; Heiß, Rafael; Lutter, Christoph; Hoppe, Matthias Wilhelm; Engelhardt, Martin; Grim, Casper; Seehaus, Frank; Forst, Raimund; Hotfiel, Thilo (Sportverletzung-Sportschaden, 2019)
BACKGROUND: Cold-water immersion (CWI) has become a popular preventive, regenerative and performance-enhancing intervention in various sports. However, its effects on soft tissue, including changes of intramuscular stiffness, are poorly understood. The purpose of this study was to investigate the effect of CWI on muscle stiffness. PATIENTS/MATERIAL AND METHODS: Thirty healthy participants were included and divided into the three following groups (n = 10): 1) post-ESU group: exercise and CWI (post-exercise set-up); 2) control group: exercise without CWI (control condition); 3) pre-ESU group: CWI alone (pre-exercise set-up). Acoustic radiation force impulse (ARFI) elastography was conducted to assess tissue stiffness (shear wave velocity, SWV). Values obtained at resting conditions (baseline, t0) were compared to values post-exercise (t1, for post-ESU group and control group), post-CWI (t2, for post-ESU group and pre-ESU group; rest for control group) and to 60-min follow-up time (t3, for all groups). Data were assessed in superficial and deep muscle tissue (rectus femoris muscle, RF; vastus intermedius muscle, VI). RESULTS: For the post-ESU group (CWI post-exercise), there was no significant difference between the time points of measurements: exercise (t1: RF: 1.63 m/s; VI: 1.54 m/s), CWI (t2: RF: 1.63 m/s; VI: 1.53 m/s) and at 60-min follow-up (t3: RF: 1.72 m/s; VI: 1.61 m/s). In the control group, a significant decrease of SWV was found between baseline conditions at t0 and post-exercise (t1) at VI (VI: 1.37 m/s; p = 0.004; RF: 1.59 m/s; p = 0.084). For t2 and t3, no further significant changes were detected. Regarding the pre-exercise set-up (pre-ESU group), a significant decrease in SWV from baseline to t2 in VI (1.60 m/s to 1.49 m/s; VI: p = 0.027) was found. CONCLUSION: This study shows varying influences of CWI on muscle stiffness. Overall, we did not detect any significant effects of CWI on muscle stiffness post-exercise. Muscle stiffness-related effects of CWI differ in the context of a pre- or post-exercise condition and have to be considered in the implementation of CWI to ensure its potential preventive and regenerative benefits.
EVALuna2:209960

Effects of renal denervation on blood pressure in hypertensive patients with end-stage renal disease: a single centre experience - Ott, Christian; Schmid, Axel; Ditting, Tilmann; Veelken, Roland; Uder, Michael; Schmieder, Roland (Clinical and Experimental Nephrology, 2019)
Background: Sympathetic nerve activity is a hallmark of hypertension in end-stage renal disease (ESRD). An initial proof-of-concept study implies that renal denervation (RDN) is feasible and safe in RDN, but overall data are limited. Methods: In this single-centre prospective pilot study six patients with ESRD and treatment resistant hypertension were consecutively included. Ambulatory blood pressure (ABP) was measured before and 6 months after RDN (Symplictiy Flex™, Medtronic Inc., Santa Rosa, CA). Moreover, haemodialysis parameters which may affect BP reduction were monitored closely. Results: In all patients bilateral RDN was successful done, without documentation of peri- or postprocedural complications. There was a significant reduction in 24-h ABP by 20 ± 17/15 ± 12 mmHg 6 months after RDN (systolic: 163 ± 16 versus 143 ± 9 mmHg, p = 0.043; diastolic: 96 ± 9 versus 81 ± 15 mmHg, p = 0.043), with similar results for day-, and nighttime values, respectively. Antihypertensive medication was kept stable as well as there was no change in haemodialysis parameters during follow-up. In addition, ultrafiltration/week (1.4 ± 1.4 versus 2.2 ± 1.4 l, p = 0.08) as well as hematocrit (measured at baseline and 6 months after RDN) (33.7 ± 4.3 versus 33.1 ± 3.9%, p = 0.715) revealed no change in volume status. Conclusion: Our single-centre pilot study not only supports current data on renal safety of RDN even in small arteries of patients with ESRD, but also enhances the knowledge towards an effective ABP reduction in this type of hypertensive patients.
CRIS-Team Scopus Importer:2019-05-07
Keywords: End-stage renal disease; Renal denervation; Treatment resistant hypertension

EFFECTS OF RENAL DENERVATION ON BLOOD PRESSURE IN PATIENTS WITH END-STAGE RENAL DISEASE: A SINGLE CENTER EXPERIENCE - Ott, C.; Schmid, Axel; Ditting, T.; Veelken, Roland; Uder, Michael; Schmieder, Roland (2018)
EVALuna2:202966

EFFECTS OF THE SGLT2 INHIBITOR EMPAGLIFLOZIN ON VASCULAR FUNCTION IN PATIENTS WITH CHRONIC HEART FAILURE - Kolwelter, Julie; Bosch, Agnes; Jung, Susanne; Linz, Peter; Kannenkeril, Dennis; Nagel, Armin Michael; Ott, Christian; Bramlage, Peter; Uder, Michael; Achenbach, Stephan; Schmieder, Roland (JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2021)
CRIS-Team WoS Importer:2021-06-04

Effects of tofersen treatment in patients with SOD1-ALS in a “real-world” setting – a 12-month multicenter cohort study from the German early access program - Wiesenfarth, Maximilian; Dorst, Johannes; Brenner, David; Elmas, Zeynep; Parlak, Özlem; Uzelac, Zeljko; Kandler, Katharina; Mayer, Kristina; Weiland, Ulrike; Herrmann, Christine; Schuster, Joachim; Freischmidt, Axel; et al. (EClinicalMedicine, 2024)
Background: In April 2023, the antisense oligonucleotide tofersen was approved by the U.S. Food and Drug Administration (FDA) for treatment of SOD1-amyotrophic lateral sclerosis (ALS), after a decrease of neurofilament light chain (NfL) levels had been demonstrated. Methods: Between 03/2022 and 04/2023, 24 patients with SOD1-ALS from ten German ALS reference centers were followed-up until the cut-off date for ALS functional rating scale revised (ALSFRS-R), progression rate (loss of ALSFRS-R/month), NfL, phosphorylated neurofilament heavy chain (pNfH) in cerebrospinal fluid (CSF), and adverse events. Findings: During the observation period, median ALSFRS-R decreased from 38.0 (IQR 32.0–42.0) to 35.0 (IQR 29.0–42.0), corresponding to a median progression rate of 0.11 (IQR −0.09 to 0.32) points of ALSFRS-R lost per month. Median serum NfL declined from 78.0 pg/ml (IQR 37.0–147.0 pg/ml; n = 23) to 36.0 pg/ml (IQR 22.0–65.0 pg/ml; n = 23; p = 0.02), median pNfH in CSF from 2226 pg/ml (IQR 1061–6138 pg/ml; n = 18) to 1151 pg/ml (IQR 521–2360 pg/ml; n = 18; p = 0.02). In the CSF, we detected a pleocytosis in 73% of patients (11 of 15) and an intrathecal immunoglobulin synthesis (IgG, IgM, or IgA) in 9 out of 10 patients. Two drug-related serious adverse events were reported. Interpretation: Consistent with the VALOR study and its Open Label Extension (OLE), our results confirm a reduction of NfL serum levels, and moreover show a reduction of pNfH in CSF. The therapy was safe, as no persistent symptoms were observed. Pleocytosis and Ig synthesis in CSF with clinical symptoms related to myeloradiculitis in two patients, indicate the potential of an autoimmune reaction. Funding: No funding was received towards this study.
CRIS-Team Scopus Importer:2024-03-01
Keywords: Amyotrophic lateral sclerosis; Antisense oligonucleotide; Early access program; SOD1; Tofersen

Effects of video-based patient preparation for MRI on clinical processes and patient experience. - Madl, Janika; Janka, Rolf Matthias; Bay, Susanne; Sturmbauer, Sarah; Rohleder, Nicolas (European Journal of Radiology, 2022)
To determine whether video-based informational or relaxational preparation reduces the number of unexpected patient-related events and scan duration more efficiently, and to assess how patients evaluate the interventions. We randomized 142 adult patients (mean age: 48 ± 16 years) to three groups. The control group (n = 48, 33.8 %) received standard care. The intervention groups watched an informational (n = 50, 35.2 %) or relaxational (n = 44, 31.0 %) video while awaiting their MRI examination. We recorded scan duration, number of motion artifacts/sequence repetitions, and patient-related incidents (e.g., interruptions, premature termination). Subjective evaluation of the interventions was provided by the patients after MRI completion. Mean scan duration for the control, relaxation, and information group was 39.38 ± 16.62 min, 32.59 ± 11.67 min, and 34.54 ± 11.91 min. Compared to the control group, scan duration was significantly shorter in the relaxation, but not in the information group (relaxation vs control: p =.019; information vs control: p =.082). The information and relaxation group did not differ significantly (p =.704). In 35 (24.6 %) patients, one or more sequences were repeated; incidents occurred in six (4.2 %) patients. Neither the frequency of repeated sequences nor incidents differed between the groups (all p >.239). Patients evaluated both videos very positively; the information video received even better evaluations (all p <.027). Additional preparation, especially information, is perceived very positively by patients and at least relaxational preparation may have a positive impact on clinical operations. PURPOSE METHODS RESULTS CONCLUSION

Effects of whole-body electromyostimulation with different impulse intensity on blood pressure changes in hyper- and normotensive overweight people. A pilot study - Kemmler, Wolfgang; Kohl, Matthias; von Stengel, Simon; Willert, Sebastian; Kast, Stephanie; Uder, Michael (Frontiers in Physiology, 2024)
Hypertension is a frequent condition in untrained middle-aged to older adults, who form the core group of whole-body electromyostimulation (WB-EMS) applicants. So far, the acute effects of varying impulse intensities on blood pressure responses have not been evaluated in normo- and hypertensive people. Thirteen hypertensive and twelve normotensive overweight WB-EMS novices, 40–70 years old, conducted the same WB-EMS protocol (20 min, bipolar, 85 Hz, 350 µs, 4 s impulse-4 s rest; combined with easy movements) with increasing impulse intensity (low, moderate, advanced) per session. Mean arterial blood pressure (MAP) as determined by automatic sphygmomanometry rose significantly (p <.001) from rest, 5 min pre-WB-EMS to immediately pre-WB-EMS assessment. Of importance, a 20-min WB-EMS application does not increase MAP further. In detail, maximum individual MAP does not exceed 128 mmHg (177 mmHg systolic or 110 mmHg diastolic) in any case. Two-min post-WB-EMS, MAP was significantly lower (p =.016) compared to immediately pre-WB-EMS. In contrast, heart rate increased significantly from immediately pre to immediately post-exercise (p <.001), though individual peak values did not exceed 140 beats/min−1 and heart rate decreased rapidly (p <.001) post-exercise. No significant differences in MAP and HR kinetics were observed for impulse intensity categories or hypertensive status. In summary, largely independently of impulse intensity and status, the acute effect of WB-EMS on MAP in novice applicants seem to be largely negligible. Although definite evidence might not have been provided by the present study, we conclude that hypertension, at least under treatment, should not be considered as a barrier for WB-EMS application in moderately old or older cohorts.
CRIS-Team Scopus Importer:2024-03-22
Keywords: blood pressure; cardiovascular; hypertension; impulse intensity; neuromuscular electrical stimulation; stimulus intensity; whole-body electromyostimulation

Effects on posture by different neuromuscular afferent stimulations and proprioceptive insoles: Rasterstereographic evaluation - Dankerl, Peter; Keller, Andrea; Häberle, Lothar; Stumptner, Thomas; Pfaff, Gregor; Uder, Michael; Forst, Raimund (Prosthetics and Orthotics International, 2014)
Proprioceptive neuromuscular stimulating insoles are increasingly applied in treating functional complaints, chronic pain, foot disorders and so on.To evaluate rasterstereography as a tool in objectifying postural changes resulting from neuromuscular afferent stimulation and proprioceptive neuromuscular stimulating insoles and to compare the respective effects on posture.This is a prospective experimental study.A total of 27 healthy volunteers were consecutively exposed to six different varying intense neuromuscular afferent stimulating test conditions at three different times. One test condition featured proprioceptive neuromuscular stimulating insoles. In each test condition, a sequence of 12 rasterstereographic recordings of back shape was documented. Changes between six different test conditions and over time for 14 posture characterising parameters were investigated, for example, trunk inclination, pelvic torsion, lateral deviation of the spine's amplitude or sagittal spinal curve.Standard deviation of our rasterstereographic measurements (±2.67 mm) was better than in most comparable reference values. Different neuromuscular stimuli were found to provoke significant changes to various posture parameters, including trunk inclination, pelvic torsion and so on ( each p < 0.001, F-tests). Proprioceptive neuromuscular stimulating insoles induced significant changes for parameter lateral deviation of the spine's amplitude (p = 0.03).Neuromuscular afferent stimulation and proprioceptive neuromuscular stimulating insoles induce postural changes, which can be detected reliably by rasterstereography.We demonstrated that rasterstereography - a radiation-free imaging modality - enables visualisation and documentation of subtle postural changes induced by varying intense neuromuscular afferent stimulation and the application of proprioceptive neuromuscular stimulating insoles.
EVALuna2:5494

Effekte von körperlicher Belastung und Kaltwasserexposition auf die mikrovaskuläre Muskelperfusion Effects of exercise and cold-water exposure on microvascular muscle perfusion - Huettel, Moritz; Schroeter, Sarah; Heiß, Rafael; Lutter, Christoph; Golditz, Tobias; Hoppe, Matthias Wilhelm; Forst, Raimund; Hafez, Hossam; Engelhardt, Martin; Grim, Casper; Hotfiel, Thilo (Ultraschall in der Medizin, 2023)
PURPOSE: Microvascular blood flow (MBF) and its intramuscular regulation are of importance for physiological responsiveness and adaptation. The quantifiable in-vivo monitoring of MBF after cycling or systemic cold-water exposure may reveal new insights into capillary regulatory mechanisms. This study aimed to assess the role of exercise and cold therapy on MBF by using contrast-enhanced ultrasound (CEUS). METHODS: Twenty healthy athletes were recruited and randomly assigned to an intervention (IG) or a control group (CG). MBF was quantified in superficial (rectus femoris, RF) and deep muscle layers (vastus intermedius, VI). Representative perfusion parameters (peak enhancement (PE) and wash-in area under the curve (WiAUC)) were measured after a standardized measurement protocol for both groups at resting conditions (t0) and after cycling (20 min., 70% Watt max, t1) for both groups, after cold-water immersion exposure for IG (15 min., 12°C) or after precisely 15 minutes of rest for CG (t2) and for both groups after 60 minutes of follow-up (t3). RESULTS: At t1, MBF in VI increased significantly compared to resting conditions in both groups in VI (p= 0.02). After the cold-water exposure (t2), there were no statistically significant changes in perfusion parameters as well as after 60 minutes of follow-up (t3) (p = 0.14). CONCLUSION: Cycling leads to an upregulation of MBF. However, cold exposure does not change the MBF. The implementation of CEUS during different physiological demands may provide deeper insight into intramuscular perfusion regulation and regenerative processes.
CRIS-Team Scopus Importer:2023-08-18

Effekt von additivem körperlichem Training zur Bisphosphonat-Therapie auf die Knochendichte: Eine systematische Übersichtsarbeit und Meta-Analyse - Klotz, Christopher; Jakob, Franz; Kohl, Matthias; von Stengel, Simon; Lange, Uwe; Thomasius, Friederike; Kerschan-Schindl, Katharina; Uder, Michael; Kemmler, Wolfgang (Osteologie, 2022)
Background Physical exercise and antiresorptive pharmacological therapy affect bone metabolism through different mechanisms. The present study addresses the question of whether bisphosphonate treatment with additional exercise training has additive effects on bone density (BMD) at the lumbar spine (LS) and/or femoral neck (SH). Methods Our systematic literature search of five electronic databases according to PRISMA included controlled trials with a duration of≥6 months with at least two study arms: (a) bisphosphonates (B), (b) bisphosphonates and exercise (B+E) published up to 26 August 2021. Studies including other pharmaceutical therapies or diseases with relevant effects on bone metabolism were excluded. The analysis was conducted as a random-effects meta-analysis. Outcome measures were standardized mean differences (SMD) for BMD changes at LS and SH. Results Our search identified four eligible studies with a total of 247 participants. In summary, compared with bisphosphonate therapy alone, the combined intervention did not demonstrate significantly higher effect sizes at LS- (SMD: 0.66, 95%-CI: - 0.63 to 1.94) or SH-BMD (0.49, - 0.42 to 1.40). We observed very high heterogeneity among the results of the included studies for both, BMD-LWS and BMD-SH (I 2: 89 and 92%, respectively). The evidence for a small study or publication bias is also quite high for both outcomes. Conclusion We could not detect a significantly superior effect of a combined intervention (B+E) compared to isolated bisphosphonate therapy on BMD at LS and/or SH. However, the eligible studies indicate a high heterogeneity, which we primarily refer to the different training protocols of the trials.
CRIS-Team Scopus Importer:2023-03-08
Keywords: Bisphosphonate; Knochendichte; körperliches Training; Meta-Analyse

Efficacy and Safety of Angioplasty Balloon Interposition in CT-Guided Percutaneous Thermal Ablation of Hepatic Malignancies to Protect Adjacent Organs - Schlappa, Michael; Wuest, Wolfgang; Siebler, Jürgen; Grützmann, Robert; Uder, Michael; Schmid, Axel (Cardiovascular and Interventional Radiology, 2022)
Purpose To evaluate the feasibility and safety of placing angioplasty balloons between the liver surface and adjacent organs in CT-guided thermal ablation of subcapsular liver malignancies in case of inadequate success of conventional dissection techniques. Materials and Methods A retrospective, single-centre database query identified 327 hepatic malignancies in 153 patients treated in 215 sessions from 2016 to 2018 by thermal ablation. Demographic data, tumour size, distance to adjacent structures, complications and long-term outcomes were assessed when ancillary procedures were performed to protect adjacent organs. Results In 21 of 327 (6.4%) ablations, thermal protection was necessary. Balloon interposition was successfully performed in 9 cases in 8 patients after hydrodissection or gas insufflation failed to separate adherent organs. Median pre- and post-balloon insertion distance was 0 mm [0-2 mm] and 17 mm [8-20 mm]. No balloons were damaged, ruptured or slid away from their initial position. Technical success of MWA and protection of adherent structures were achieved in all procedures. In a median follow-up of 11.5 months [0-49 months], the local control rate was 88.9% as 1 patient was treated twice with an interval of 3 months for local recurrence. Three non-process-related major complications and 1 minor complication occurred. Conclusion Balloon interposition is a safe and feasible method to enable thermal ablation to a greater number of patients, even after established thermo-protective techniques fail to separate the colon or stomach from the liver surface.
CRIS-Team WoS Importer:2022-07-22

Efficacy and safety of combined intraventricular fibrinolysis with lumbar drainage for prevention of permanent shunt dependency after intracerebral hemorrhage with severe ventricular involvement: A randomized trial and individual patient data meta-analysi - Staykov, Dimitre; Kuramatsu, Joji; Bardutzky, Juergen; Volbers, Bastian; Gerner, Stefan; Kloska, Stephan; Dörfler, Arnd; Schwab, Stefan; Huttner, Hagen (Annals of Neurology, 2017)
Intraventricular hemorrhage (IVH) is a negative prognostic factor in intracerebral hemorrhage (ICH) and is associated with permanent shunt dependency in a substantial proportion of patients post-ICH. IVH treatment by intraventricular fibrinolysis (IVF) was recently linked to reduced mortality rates in the CLEAR III study and IVF represents a safe and effective strategy to hasten clot resolution that may reduce shunt rates. Additionally, promising results from observational studies reported reductions in shunt dependency for a combined treatment approach of IVF plus lumbar drains (LDs). The present randomized, controlled trial investigated efficacy and safety of a combined strategy-IVF plus LD versus IVF alone-on shunt dependency in patients with ICH and severe IVH.This randomized, open-label, parallel-group study included patients aged 18 to 85 years, prehospital modified Rankin Scale <=3, ICH volume < 60ml, Glasgow Coma Scale of <9, and severe IVH with tamponade of the third and fourth ventricles requiring placement of external ventricular drainage (EVD). Over a 3-year recruitment period, patients were allocated to either standard treatment (control group receiving IVF consisting of 1mg of recombinant human tissue plasminogen activator every 8 hours until clot clearance of third and fourth ventricles) or a combined treatment approach of IVF and-upon clot clearance of third and fourth ventricles-subsequent placement of an LD for drainage of cerebrospinal fluid (CSF; intervention group). The primary endpoint consisted of permanent shunt placement indicated after a total of three unsuccessful EVD clamping attempts or need for CSF drainage longer than 14 days in both groups. Secondary endpoints included IVF- and LD-related safety, such as bleeding or infections, and functional outcome at 90 and 180 days. Conducted endpoint analyses used individual patient data meta-analyses. The study was registered at clinicaltrials.gov (NCT01041950).The trial was stopped upon predefined interim analysis after 30 patients because of significant efficacy of tested intervention. The primary endpoint was analyzed without dropouts and was reached in 43% (7 of 16) of the control group versus 0% (0 of 14) of the intervention group (p = 0.007). Meta-analyses were based on overall 97 patients, 45 patients receiving IVF plus LD versus 42 with IVF only. Meta-analyses on shunt dependency showed an absolute risk reduction of 24% for the intervention (LD, 2.2% [1 of 45] vs no-LD, 26.2% [11 of 42]; odds ratio [OR] = 0.062; confidence interval [CI], 0.011-0.361; p = 0.002). Secondary endpoints did not show significant differences for CSF infections (OR = 0.869;CI, 0.445-1.695; p = 0.680) and functional outcome at 90 days (OR = 0.478; CI, 0.190-1.201; p = 0.116), yet bleeding complications were significantly reduced in favor of the intervention (OR = 0.401; CI, 0.302-0.532; p < 0.001).The present trial and individual patient data meta-analyses provide evidence that, in patients with severe IVH, as compared to IVF alone, a combined approach of IVF plus LD treatment is feasible and safe and significantly reduces rates of permanent shunt dependency for aresorptive hydrocephalus post-ICH. ANN NEUROL 2017;81:93-103.
EVALuna2:22478

Efficient drug-delivery using magnetic nanoparticles–biodistribution and therapeutic effects in tumour bearing rabbits. - Peukert, Wolfgang; Tietze, Rainer; Lyer, Stefan; Dürr, Stephan; Struffert, Tobias; Engelhorn, Tobias; Schwarz, Marc; Eckert, Elisabeth; Göen, Thomas; Vasylyev, Serhiy; Trahms, Lutz; Dörfler, Arnd; et al. (Nanomedicine : nanotechnology, biology, and medicine, 2013)
To treat tumours efficiently and spare normal tissues, targeted drug delivery is a promising alternative to conventional, systemic administered chemotherapy. Drug-carrying magnetic nanoparticles can be concentrated in tumours by external magnetic fields, preventing the nanomaterial from being cleared by metabolic burden before reaching the tumour. Therefore in Magnetic Drug Targeting (MDT) the favoured mode of application is believed to be intra-arterial. Here, we show that a simple yet versatile magnetic carrier-system (hydrodynamic particles diameter <200nm) accumulates the chemotherapeutic drug mitoxantrone efficiently in tumours. With MDT we observed the following drug accumulations relative to the recovery from all investigated tissues: tumour region: 57.2%, liver: 14.4%, kidneys: 15.2%. Systemic intra-venous application revealed different results: tumour region: 0.7%, liver: 14.4 % and kidneys: 77.8%. The therapeutic outcome was demonstrated by complete tumour remissions and a survival probability of 26.7% (P=0.0075). These results are confirming former pilot experiments and implying a milestone towards clinical studies. FROM THE CLINICAL EDITOR This team of investigators studied drug carrying nanoparticles for magnetic drug targeting (MDT), demonstrating the importance of intra-arterial administration resulting in improved clinical outcomes in the studied animal model compared with intra-venous.
Keywords: treatment; drug; delievery; magnetic; nanoparticles

EFhd2/Swiprosin-1 is a common genetic determinator for sensation-seeking/low anxiety and alcohol addiction - Mielenz, Dirk; Reichel, Martin; Jia, T.; Quinlan, E. B.; Stöckl, Thomas; Mettang, M.; Zilske, Daniel; Kirmizi Alsan, Elif; Schoenberger, P.; Praetner, M.; Huber, Sabine; Amato, Davide; et al. (Molecular Psychiatry, 2017)
In many societies, the majority of adults regularly consume alcohol. However, only a small proportion develops alcohol addiction. Individuals at risk often show a high sensation-seeking/low-anxiety behavioural phenotype. Here we asked which role EF hand domain containing 2 (EFhd2; Swiprosin-1) plays in the control of alcohol addiction-associated behaviours. EFhd2 knockout (KO) mice drink more alcohol than controls and spontaneously escalate their consumption. This coincided with a sensation-seeking and low-anxiety phenotype. A reversal of the behavioural phenotype with β-carboline, an anxiogenic inverse benzodiazepine receptor agonist, normalized alcohol preference in EFhd2 KO mice, demonstrating an EFhd2-driven relationship between personality traits and alcohol preference. These findings were confirmed in a human sample where we observed a positive association of the EFhd2 single-nucleotide polymorphism rs112146896 with lifetime drinking and a negative association with anxiety in healthy adolescents. The lack of EFhd2 reduced extracellular dopamine levels in the brain, but enhanced responses to alcohol. In confirmation, gene expression analysis revealed reduced tyrosine hydroxylase expression and the regulation of genes involved in cortex development, Eomes and Pax6, in EFhd2 KO cortices. These findings were corroborated in Xenopus tadpoles by EFhd2 knockdown. Magnetic resonance imaging (MRI) in mice showed that a lack of EFhd2 reduces cortical volume in adults. Moreover, human MRI confirmed the negative association between lifetime alcohol drinking and superior frontal gyrus volume. We propose that EFhd2 is a conserved resilience factor against alcohol consumption and its escalation, working through Pax6/Eomes. Reduced EFhd2 function induces high-risk personality traits of sensation-seeking/low anxiety associated with enhanced alcohol consumption, which may be related to cortex function.
EVALuna2:4036

EFHD2/SWIPROSIN-1 IS A CONSERVED RESILIENCE FACTOR AGAINST ALCOHOL DRINKING ESCALATION - Müller, Christian P.; Reichel, Martin; Jia, T.; Quinlan, E. B.; Schambony, Alexandra; Bäuerle, Tobias; Eulenburg, Volker; Lourdusamy, A.; Schumann, G.; Mielenz, Dirk (2018)
EVALuna2:35243

EGFL7 enhances surface expression of integrin α5β1 to promote angiogenesis in malignant brain tumors - Stankovic, Nevenka Dudvarski; Bicker, Frank; Keller, Stefanie; Jones, David T. W.; Harter, Patrick N.; Kienzle, Arne; Gillmann, Clarissa; Arnold, Philipp; Golebiewska, Anna; Keunen, Olivier; Giese, Alf; Von Deimling, Andreas; et al. (Embo Molecular Medicine, 2018)
Glioblastoma (GBM) is a typically lethal type of brain tumor with a median survival of 15 months postdiagnosis. This negative prognosis prompted the exploration of alternative treatment options. In particular, the reliance of GBM on angiogenesis triggered the development of anti-VEGF (vascular endothelial growth factor) blocking antibodies such as bevacizumab. Although its application in human GBM only increased progression-free periods but did not improve overall survival, physicians and researchers still utilize this treatment option due to the lack of adequate alternatives. In an attempt to improve the efficacy of anti-VEGF treatment, we explored the role of the egfl7 gene in malignant glioma. We found that the encoded extracellular matrix protein epidermal growth factor-like protein 7 (EGFL7) was secreted by glioma blood vessels but not glioma cells themselves, while no major role could be assigned to the parasitic miRNAs miR-126/126*. EGFL7 expression promoted glioma growth in experimental glioma models in vivo and stimulated tumor vascularization. Mechanistically, this was mediated by an upregulation of integrin α5β1 on the cellular surface of endothelial cells, which enhanced fibronectin-induced angiogenic sprouting. Glioma blood vessels that formed in vivo were more mature as determined by pericyte and smooth muscle cell coverage. Furthermore, these vessels were less leaky as measured by magnetic resonance imaging of extravasating contrast agent. EGFL7-inhibition using a specific blocking antibody reduced the vascularization of experimental gliomas and increased the life span of treated animals, in particular in combination with anti-VEGF and the chemotherapeutic agent temozolomide. Data allow for the conclusion that this combinatorial regimen may serve as a novel treatment option for GBM.
EVALuna2:212698

Einfluss neuer Techniken in der Bildgebung der Niere - Uder, Michael; Heinrich, Marc Christopher; Jäger, Florian; Hornegger, Joachim; Schmieder, Roland; Janka, Rolf Matthias (Nephrologe, 2009)
Computed tomography and magnetic resonance imaging have developed very rapidly in recent years. Today these methods are capable not only of morphological assessment of the kidneys but also provide data of a functional nature. Urography by MRI and CT have long been established in clinical routine. Other techniques such as blood level oxygenation-dependent (BOLD), diffusion-weighted, and renal perfusion imaging using MRI or CT are used almost exclusively for research purposes, but they also have many possibilities for renal applications under study conditions in diagnostics and for monitoring vascular and parenchymatous disorders. © 2009 Springer-Verlag.

Ein klinisch anwendbares Neuronales Netzwerk zur Klassifikation suspekter Läsionen in der Mamma-MRT - Ellmann, Stephan; Bielowski, Christian; Wenkel, Evelyn; Vesal, Sulaiman; Maier, Andreas; Uder, Michael; Bäuerle, Tobias (Fortschritte auf dem Gebiete der Röntgenstrahlen, 2018)
UnivIS-Import:2018-09-05:Pub.2018.tech.IMMD.IMMD5.einkli

Einsatz bildgebender Verfahren bei der Früherkennung von Mesotheliomen - Ludwig, Kathrin; Eisenkolb, Alexander; Hering, Jan Philipp; Rehbock, Beate; Bayerl, Nadine; Hofmann-Prei, Karina; Kraus, Thomas (Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2021)
CRIS-Team Scopus Importer:2021-10-01

Elbow Injuries Detected on Magnetic Resonance Imaging in Athletes Participating in the Rio de Janeiro 2016 Summer Olympic Games - Alizai, Hamza; Engebretsen, Lars; Jarraya, Mohamed; Roemer, Frank; Guermazi, Ali (Journal of Computer Assisted Tomography, 2019)
BACKGROUND: Athletes are prone to both acute and chronic overuse injuries of the elbow joint. The purpose of this study was to describe the frequency, anatomic distribution, and severity of magnetic resonance imaging (MRI)-detected elbow joint injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics. METHODS: All sports injuries reported by the National Olympic Committee medical teams and the Organizing Committee medical staff during the 2016 Summer Olympics were analyzed. Magnetic resonance imaging was performed at the International Olympic Committee's polyclinic within the Olympic Village, using 3- and 1.5-T scanners. The MRIs were read centrally and retrospectively by musculoskeletal radiologists with expertise in sports injuries. The distribution of elbow joint injuries by anatomic location and sports discipline and the severity of injuries were recorded. RESULTS: A total of 1101 injuries were reported in the 11,274 athletes from 207 teams at the Games. Central review of MRI revealed elbow joint injuries in 15 athletes (60% male; median age, 22 years; range, 18-39 years). Ligamentous injuries were most common, with injuries of the ulnar collateral ligament being the most prevalent (n = 12; 80%), followed by the common flexor tendon (n = 8; 53%). Osseous injuries were far less common (n = 3; 20%), with no acute fractures seen. Weightlifting (n = 4; 27%) and judo (n = 4; 27%) athletes were most commonly affected. CONCLUSION: Magnetic resonance imaging-detected elbow injuries during the 2016 Summer Olympics affected mainly the ulnar collateral ligament and the common flexor tendon, with the highest occurrence in weight lifting and judo.
CRIS-Team Scopus Importer:2019-12-10

Elevated tissue sodium deposition in patients with type 2 diabetes on hemodialysis detected by 23Na magnetic resonance imaging - Kopp, Christoph; Linz, Peter; Maier, Carolin; Wabel, Peter; Hammon, Matthias; Nagel, Armin Michael; Rosenhauer, Daniela; Horn, Stephan; Uder, Michael; Luft, Friedrich C.; Titze, Jens; Dahlmann, Anke (Kidney International, 2018)
Long-term elevated blood sugar levels result in tissue matrix compositional changes in patients with diabetes mellitus type 2 (T2DM). We hypothesized that hemodialysis patients with T2DM might accumulate more tissue sodium than control hemodialysis patients. To test this, 23Na magnetic resonance imaging (23Na MRI) was used to estimate sodium in skin and muscle tissue in hemodialysis patients with or without T2DM. Muscle fat content was estimated by 1H MRI and tissue sodium content by 23Na MRI pre- and post-hemodialysis in ten hemodialysis patients with T2DM and in 30 matched control hemodialysis patients. We also assessed body fluid distribution with the Body Composition Monitor. 1H MRI indicated a tendency to higher muscle fat content in hemodialysis patients with T2DM compared to non-diabetic hemodialysis patients. 23Na MRI indicated increased sodium content in muscle and skin tissue of hemodialysis patients with T2DM compared to control hemodialysis patients. Multi-frequency bioimpedance was used to estimate extracellular water (ECW), and excess ECW in T2DM hemodialysis patients correlated with HbA1c levels. Sodium mobilization during hemodialysis lowered muscle sodium content post-dialysis to a greater degree in T2DM hemodialysis patients than in control hemodialysis patients. Thus, our findings provide evidence that increased sodium accumulation occurs in hemodialysis patients with T2DM and that impaired serum glucose metabolism is associated with disturbances in tissue sodium and water content.
EVALuna2:34700

Eligibility of Endovascular Repair for Popliteal Artery Aneurysms According the Instructions for Use - Hellwig, Konstantin; Hoffmann, Lisa; Rother, Ulrich; Meyer, Alexander; Lang, Werner; Schmid, Axel (Annals of Vascular Surgery, 2020)
Background: Popliteal artery aneurysms (PAAs) are the most common peripheral aneurysms. Although rare and often asymptomatic, there is a significant risk of thrombosis, embolism, and limb loss. The aim of this study was to evaluate the eligibility for endovascular repair of patients treated for symptomatic and asymptomatic PAAs in accordance with the instructions for use (IFU). Methods: All patients treated for PAA with open surgical repair between the years 2010 and 2017 were analyzed if suitable for endovascular treatment. Preoperative imaging was reviewed for applicability with an interventional radiologist and 2 vascular surgeons. Evaluation was performed in accordance with the following criteria adopted from the IFU of the Gore ® Viabahn stent graft: at least a single-vessel tibial runoff, proximal and distal landing zone more than 2 cm, no large difference in vessel diameter proximal and distal to the aneurysm, no overstenting of significant collaterals necessary, and no inadequate kinking of the artery. The patients were classified in 3 categories: the patient was eligible, endovascular treatment was feasible, and endovascular treatment was not appropriate. Results: 51 patients with 61 symptomatic and asymptomatic PAAs were identified. Forty-five cases were asymptomatic, 11 cases showed clinical symptoms such as claudication, and in 5 cases, the patients presented with acute ischemia. Twenty-four patients were eligible for endovascular intervention, 14 cases were feasible, and in 23 cases, it was not appropriate in accordance with the IFU. Conclusions: In this study, more than one-third of the patients with PAA were not eligible for endovascular treatment in accordance with the IFU and another 23 % showed substantial reasons against endovascular treatment. These data suggest that endovascular repair remains a treatment option for selected patients only. Cross-sectional imaging is mandatory for procedure selection.
CRIS-Team Scopus Importer:2020-05-12

Empfehlungen für ein körperliches Training zur Sturzprävention bei älteren, selbständig lebenden Menschen - Schöne, Daniel; Gross, Michaela; von Stengel, Simon; Kohl, Matthias; Kladny, Bernd; Gosch, Markus; Sieber, Cornel; Peters, Stefan; Kiesswetter, Eva; Becker, Clemens; Kemmler, Wolfgang (Osteologie, 2023)
Falls in older age are the most important risk factor for fractures. Epidemiological studies have identified numerous risk factors for falls, many of which are modifiable through structured physical training. This article describes the evidence on content and methods of physical training for preventing falls. It also addresses the dosing of exercise and the potential of such training for reducing the impact of falls. Current results show high evidence that multimodal programs, balance and functional exercises, and Tai Chi are effective in preventing falls compared to inactive control groups. In particular, the role of challenging balance training is crucial. Newer training contents/method variations are also effective, including stepping programs and perturbation training. The latter seems to have notable effects in shorter periods. While some interventions must be supervised, effective individual home training programs also exist. Except for perturbation training, programs should be conducted three times a week for at least three months. A potentially periodized, permanent training ensures long-lasting effects. There is insufficient evidence to recommend isolated resistance, endurance, or flexibility training as well as aquatic exercise, dancing, and interactive cognitive-motor interventions as effective training in fall prevention. They are however, largely effective in influencing fall risk factors or facilitating an entry into training. There is very limited evidence of the fall process being influenced by exercise. In healthy older adults, falling, catching, rolling techniques and stepping are suitable for reducing the impact of self-induced falls. In this regard, there are no data on real-life fall-related injuries.
CRIS-Team Scopus Importer:2023-09-22
Keywords: aged; exercise; fall impact; fall prevention; training components

Endovascular interventions for subarachnoid hemorrhage - Dörfler, Arnd (Cambridge University Press, 2013)
The primary treatment goal of cerebral aneurysms is prevention of rupture. Surgical clipping has been the treatment modality of choice for both ruptured and unruptured cerebral aneurysms for decades. Just over 20 years ago endovascular treatment was mainly restricted to those patients with aneurysms unsuitable or inaccessible for clipping due to size or location, or in whom surgical clipping was contraindicated because of the general medical condition. Nowadays, the increasing experience and development of appropriate devices has widened the indications, and endovascular therapy has become more than an alternative to surgical treatment. Attempts to induce thrombosis of systemic aneurysms either by introducing foreign bodies or by application of electrical or thermic injury date back to the first half of the 19th century. Velpeau (1831) independently described a method of introducing arterial thrombosis by inserting a needle into the aneurysmal lumen and withdrawing it after thrombus had formed. In 1941 Werner et al. reported successful electrothermic thrombosis of an acute ruptured intracranial aneurysm through a transorbital approach. In 1963 Gallagher proposed a technique of inducing thrombosis of intracranial aneurysms by high-speed delivery of dog or horse hairs into the aneurysm using a pneumatic gun (‘pilojection’). However, despite encouraging early results these methods did not gain acceptance.
CRIS-Team Scopus Importer:2022-08-05

Endovascular stenting of an HVAD (TM) outflow graft pseudoaneurysm that exerts compression and kinking stenosis on the soft portion of the prosthesis - Elbayomi, Mohamed; Weyand, Michael; Uder, Michael; May, Matthias; Steger, Katrin; Roth, Jan-Peter; Tandler, Rene (Clinical Case Reports, 2023)
Key Clinical MessageComplex presentations of MCS patients may necessitate a multidisciplinary approach involving HF cardiologists, CT surgeons, advanced cardiac imagers, and interventional cardiologists in order to define the optimal management strategy. Left ventricle assist devices (LVADs) provide life-sustaining treatment for patients with terminal heart failure, but their intricacy allows for complications. One complication is LVAD outflow graft obstruction due to the graft's intraluminal thrombus or extraluminal compression. It may be treated endovascularly with stenting. We report an endovascular stenting of an outflow tract in HVAD (TM) (HeartWare Inc.) due to a pseudoaneurysm causing compression and kinking stenosis.
CRIS-Team WoS Importer:2023-06-02

Endovascular treatment in patients with large vessel occlusion: reduced mortality despite minimal penumbra - Schmidt, Manuel; Breuer, Lorenz; Kallmünzer, Bernd; Schwab, Stefan; Dörfler, Arnd; Engelhorn, Tobias; Hölter, Philip (Neuroradiology, 2019)
Purpose: In patients with acute ischemic stroke (AIS) caused by large vessel occlusion (LVO), endovascular treatment (EVT) is highly effective for emergency revascularization. However, data on functional outcome are lacking for patients, which show no or minimal mismatch between ischemic core and penumbra. Methods: Forty-five patients with AIS due to LVO of the anterior circulation were retrospectively analyzed within 6 h since onset when administered to our department. In all patients, there was no relevant penumbra according to CT perfusion (CTP). Functional outcome, defined by the modified Rankin Scale (mRS) at 30 and 90 days, was analyzed according to LVO treatment (EVT versus non-EVT). Confounding was addressed by multivariable regression analyses. Results: mRS values at 30 days (p = 0.002) and 90 days (p = 0.005) after AIS occurrence were significantly lower in patients who had received EVT. There was no significant difference regarding good functional outcome, as measured by mRS of 0–2 at 30 (p = 0.432) and 90 days, respectively (p = 0.186). Mortality was significantly reduced in patients undergoing EVT at 30-day (p < 0.001) and at 90-day follow-up (p = 0.003), respectively. Multivariable regression analyses revealed that EVT was associated with reduced mortality at 30 (OR 0.091; CI (0.013–0.612); p = 0.014) and 90 days (OR 0.134; CI (0.021–0.857); p = 0.034) after AIS. Conclusions: Despite a small and highly selected patient collective, our study indicates that AIS patients with minimal penumbra in CTP might benefit from EVT in terms of reduced mortality at 30 and 90 days after AIS. However, in this group of patients, we could not prove favorable functional outcome at 30 and 90 days, despite receiving EVT.
CRIS-Team Scopus Importer:2019-09-17
Keywords: CTP; Endovascular treatment; Mortality; Penumbra; Stroke

Endovascular treatment of patient with multiple extracranial large vessel stenosis and coexistent unruptured wide-neck intracranial aneurysm using a WEB device and Szabo-technique - Cherednychenko, Yurii; Engelhorn, Tobias; Miroshnychenko, Andrii; Zorin, Mikola; Dzyak, Liudmila; Tsurkalenko, Olena; Cherednychenko, Natalia (Radiology Case Reports, 2020)
The coexistence of severe extracranial large vessel stenosis and unruptured intracranial aneurysms is not rare. There are different treatment approaches for these conditions, such as initial treatment of the aneurysm before revascularization of the stenosis; single-stage endovascular treatment of both lesions; stenosis eliminating followed by treatment of the aneurysm, or without treating the aneurysm. But, taking into account the risk of aneurysm rupture on the one hand and the risk of ischemic stroke on the other, it is sometimes difficult to choose the right management strategy. Despite this fact, there are still no guidelines or consensus on the management of these coexistent lesions. The article describes a clinical case of endovascular treatment of multiple extracranial stenosis and coexistent unruptured wide-neck aneurysm of the middle cerebral artery. The endovascular treatment of the carotid stenosis and aneurysm using a woven endobridge device was performed in one session; endovascular treatment of vertebral artery stenosis with Szabo technique was performed in another session.
CRIS-Team Scopus Importer:2020-10-16
Keywords: Cerebral aneurysm; Endovascular treatment; Stenosis of extracranial vessel; Szabo-technique; WEB device

Endovascular Versus Medical Management of Posterior Cerebral Artery Occlusion Stroke: The PLATO Study. - Nguyen, Thanh N.; Qureshi, Muhammad M.; Strambo, Davide; Strbian, Daniel; Räty, Silja; Herweh, Christian; Abdalkader, Mohamad; Olive-Gadea, Marta; Ribo, Marc; Psychogios, Marios; Fischer, Urs; Nguyen, Anh; et al. (Stroke, 2023)
BACKGROUND: The optimal management of patients with isolated posterior cerebral artery occlusion is uncertain. We compared clinical outcomes for endovascular therapy (EVT) versus medical management (MM) in patients with isolated posterior cerebral artery occlusion. METHODS: This multinational case-control study conducted at 27 sites in Europe and North America included consecutive patients with isolated posterior cerebral artery occlusion presenting within 24 hours of time last well from January 2015 to August 2022. Patients treated with EVT or MM were compared with multivariable logistic regression and inverse probability of treatment weighting. The coprimary outcomes were the 90-day modified Rankin Scale ordinal shift and ≥2-point decrease in the National Institutes of Health Stroke Scale. RESULTS: Of 1023 patients, 589 (57.6%) were male with median (interquartile range) age of 74 (64-82) years. The median (interquartile range) National Institutes of Health Stroke Scale was 6 (3-10). The occlusion segments were P1 (41.2%), P2 (49.2%), and P3 (7.1%). Overall, intravenous thrombolysis was administered in 43% and EVT in 37%. There was no difference between the EVT and MM groups in the 90-day modified Rankin Scale shift (aOR, 1.13 [95% CI, 0.85-1.50]; P=0.41). There were higher odds of a decrease in the National Institutes of Health Stroke Scale by ≥2 points with EVT (aOR, 1.84 [95% CI, 1.35-2.52]; P=0.0001). Compared with MM, EVT was associated with a higher likelihood of excellent outcome (aOR, 1.50 [95% CI, 1.07-2.09]; P=0.018), complete vision recovery, and similar rates of functional independence (modified Rankin Scale score, 0-2), despite a higher rate of SICH and mortality (symptomatic intracranial hemorrhage, 6.2% versus 1.7%; P=0.0001; mortality, 10.1% versus 5.0%; P=0.002). CONCLUSIONS: In patients with isolated posterior cerebral artery occlusion, EVT was associated with similar odds of disability by ordinal modified Rankin Scale, higher odds of early National Institutes of Health stroke scale improvement, and complete vision recovery compared with MM. There was a higher likelihood of excellent outcome in the EVT group despite a higher rate of symptomatic intracranial hemorrhage and mortality. Continued enrollment into ongoing distal vessel occlusion randomized trials is warranted.
EVALuna2:536990

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study - Gitsioudis, Gitsios; Schmahl, Christina; Missiou, Anna; Voss, Andreas; Schuessler, Alena; Abdel-Aty, Hassan; Buss, Sebastian J.; Mueller, Dirk; Vembar, Mani; Bryant, Mark; Kauczor, Hans-Ulrich; Giannitsis, Evangelos; et al. (PLoS ONE, 2016)
OBJECTIVES: We sought to investigate the association of epicardial adipose tissue (eCAT) volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD). METHODS AND RESULTS: 177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT) and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA) between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing <50% (median (interquartile range, IQR): 108 (73-167) cm3 vs. 119 (82-196) cm3, p = 0.04). Multivariate regression analysis demonstrated an independent association eCAT volume with plaque burden by number of lesions (R2 = 0.22, rpartial = 0.29, p = 0.026) and CAD severity by lumen narrowing (R2 = 0.22, rpartial = 0.23, p = 0.038) after adjustment for age, diabetes mellitus, hyperlidipemia, body-mass-index (BMI), hs-CRP and hs-TnT. Univariate Cox proportional hazards regression analysis identified a significant association for both increased eCAT volume and maximal lumen narrowing with all cardiac events. Multivariate Cox proportional hazards regression analysis revealed an independent association of increased eCAT volume with all cardiac events after adjustment for age, >3 risk factors, presence of CAD, hs-CRP and hs-TnT. CONCLUSION: Epicardial adipose tissue volume is independently associated with plaque burden and maximum luminal narrowing by CCTA and may serve as an independent predictor for cardiac outcomes in patients at intermediate risk for CAD.
EVALuna2:36052

Epidemiology of imaging-detected bone stress injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympics - Hayashi, Daichi; Jarraya, Mohamed; Engebretsen, Lars; Crema, Michel D.; Roemer, Frank; Skaf, Abdalla; Guermazi, Ali (British Journal of Sports Medicine, 2018)
BACKGROUND: Bone stress injuries are common in high-level athletics. AIM: To describe the demographics, frequency and anatomical location of stress injuries (ie, stress reaction and stress fractures) in athletes at the Rio de Janeiro 2016 Summer Olympic Games. METHODS: We recorded all sports injuries at the Rio de Janeiro 2016 Summer Olympics reported by the National Olympic Committee (NOC) medical teams and in the polyclinic and medical venues. Imaging was performed through the official IOC clinic within the Olympic Village, using digital X-ray cameras and 3T and 1.5T magnetic resonance (MR) scanners. Images were read centrally and retrospectively by musculoskeletal radiologists with expertise in sports injuries. RESULTS: 11 274 athletes (5089 women (45%), 6185 men (55%)) from 207 NOCs participated in the study. 1101 injuries were reported. Imaging revealed 9 stress fractures (36%) and 16 stress reactions (64%) in 18 female and 7 male athletes (median age 25 years, age range 18-32). Stress injuries were mostly in the lower extremities (84%), particularly tibia (44%) and metatarsals (12%), with two in the lumbar spine (8%). Stress injuries were most common in track and field athletes (44%) followed by volleyball players (16%), gymnastics (artistic) (12%) and other type of sports. CONCLUSIONS: Twenty-five bone stress injuries were reported, more commonly in women, mostly in the lower extremities and most commonly in track and field athletes. Our study demonstrates the importance of early imaging with MRI to detect stress reactions before they can progress to stress fractures.
EVALuna2:36258

Epidemiology of imaging-detected tendon abnormalities in athletes participating in the Rio de Janeiro 2016 Summer Olympics - Jarraya, Mohamed; Crema, Michel D.; Engebretsen, Lars; Teytelboym, Oleg M.; Hayashi, Daichi; Roemer, Frank; Skaf, Abdalla Y.; Guermazi, Ali (British Journal of Sports Medicine, 2018)
BACKGROUND: Tendon abnormalities are prevalent among both elite and non-elite athletes. Cross-sectional imaging modalities are used to confirm and evaluate the severity of such lesions. AIM: To describe the demographics, prevalence, anatomical location and characteristics of tendon abnormalities in athletes who participated in the Rio de Janeiro 2016 Summer Olympic Games. METHODS: We recorded all sports injuries reported by the National Olympic Committee (NOC) medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the official IOC clinic within the Olympic Village, using digital ultrasound machines and 3T and 1.5T MR scanners. Image interpretation was performed centrally by board-certified musculoskeletal radiologists with expertise in sports injuries. RESULTS: In total, 11 274 athletes (5089 women (45%), 6185 men (55%)) from 207 NOCs were included. NOC and Rio de Janeiro 2016 medical staff reported 1101 injuries. Central review of radiological images revealed 156 tendon abnormalities in 109 athletes (51.2% male, mean age: 26.8, range 18-39). The supraspinatus tendon was the most commonly involved tendon (31 cases, 19.9%), followed by the Achilles tendon (20 cases, 12.8%) and patellar and infraspinatus tendons (12 cases, 7.7%). Tendon abnormalities were most commonly seen in track and field athletes (54 abnormalities, 34.6%). CONCLUSION: 156 tendon abnormalities were reported, most commonly in track and field athletes, and involving mainly the shoulder tendons, as well as Achilles and patellar tendons.
EVALuna2:34712

Erratum to 'Clinical/perfusion CT CBV mismatch as prognostic factor in intraarterial thrombectomy in acute anterior circulation stroke' (Clinical Neurology and Neurosurgery (2014) 121, (39-45)) - Saake, Marc; Breuer, Lorenz; Gölitz, Philipp; Köhrmann, Martin; Schwab, Stefan; Dörfler, Arnd; Kloska, Stephan (Clinical Neurology and Neurosurgery, 2014)
CRIS-Team Scopus Importer:2022-08-05

Erratum to: Stress examination of flexor tendon pulley rupture in the crimp grip position: a 1.5-Tesla MRI cadaver study - Bayer, Thomas; Fries, Simon; Schweizer, Andreas; Schoeffl, Isabelle; Janka, Rolf Matthias; Bongartz, Georg (Skeletal Radiology, 2015)
EVALuna2:14346

Erratum zu: Interdisziplinäre neurovaskuläre Netzwerke: eine Standortbestimmung - Röther, J.; Busse, O.; Berlis, A.; Dörfler, Arnd; Groden, Ch; Hamann, G.; Jansen, O.; Meixensberger, J.; Müller, O.; Regelsberger, J.; Steinmetz, H.; Vatter, H.; et al. (Der Nervenarzt, 2020)
CRIS-Team Scopus Importer:2020-11-13

Essentials in intraoperative indocyanine green videoangiography assessment for intracranial aneurysm surgery: conclusions from 295 consecutively clipped aneurysms and review of the literature - Roessler, Karl; Krawagna, Maximilian; Dörfler, Arnd; Buchfelder, Michael; Ganslandt, Oliver (Neurosurgical Focus, 2014)
Indocyanine green (ICG) videoangiography (VA) in cerebral aneurysm surgery allows confirmation of blood flow in parent, branching, and perforating vessels as well as assessment of remnant aneurysm parts after clip application. A retrospective analysis and review of the literature were conducted to determine the current essential advantages of ICG-VA in aneurysm surgery.The authors retrospectively evaluated all aneurysm cases treated with the aid of intraoperative ICG-VA at a single institution between 2007 and 2013. They also analyzed the literature published since the initial description of ICG-VA in 2003.Two hundred forty-six procedures were performed in 232 patients harboring 295 aneurysms. The patients, whose mean age was 54 years, consisted of 159 women and 73 men. One hundred twenty-four surgeries were performed after subarachnoid hemorrhage, and 122 were performed for incidental aneurysms. Single aneurysms were clipped in 185 patients, and multiple aneurysms were clipped in 47 (mean aneurysm diameter 6.9 mm, range 2-40 mm). No complications associated with ICG-VA occurred. Intraoperative microvascular Doppler ultrasonography was performed before ICG-VA in all patients, and postoperative digital subtraction angiography (DSA) studies were available in 121 patients (52.2%) for retrospective comparative analysis. In 22 (9%) of 246 procedures, the clip position was modified intraoperatively as a consequence of ICG-VA. Stenosis of the parent vessels (16 procedures) or occlusion of the perforators (6 procedures), not detected by micro-Doppler ultrasonography, were the most common problems demonstrated on ICG-VA. In another 11 procedures (4.5%), residual perfusion of the aneurysm was observed and one or more additional clips were applied. Vessel stenosis or a compromised perforating artery occurred independent of aneurysm location and was about equally common in middle cerebral artery and anterior communicating artery aneurysms. In 2 procedures (0.8%), aneurysm puncture revealed residual blood flow within the lesion, which had not been detected by the ICG-VA. In the postoperative DSA studies, unexpected small (< 2 mm) aneurysm neck remnants, which had not been detected on intraoperative ICG-VA, were found in 11 (9.1%) of 121 patients. However, these remnants remained without consequence except in 1 patient with a 6-mm residual aneurysm dome, which was subsequently embolized with coils.In a large cohort of consecutive patients, ICG-VA proved to be a helpful intraoperative tool and led to a significant intraoperative clip modification rate of 15%. However, small, < 2-mm-wide neck remnants and a 6-mm residual aneurysm were missed by intraoperative ICG-VA in up to 10% of patients. Results in this study confirm that DSA is indispensable for postoperative quality assessment in complex aneurysm surgery.
EVALuna2:22828

Estimating the body portion of CT volumes by matching histograms of visual words - Feulner, Johannes; Zhou, S. Kevin; Seifert, Sascha; Hornegger, Joachim; Comaniciu, Dorin; Cavallaro, Alexander Josef (Medical Imaging 2009 - Image Processing, 2009)
Being able to automatically determine which portion of the human body is shown by a CT volume image offers various possibilities like automatic labeling of images or initializing subsequent image analysis algorithms. This paper presents a method that takes a CT volume as input and outputs the vertical body coordinates of its top and bottom slice in a normalized coordinate system whose origin and unit length are determined by anatomical landmarks. Each slice of a volume is described by a histogram of visual words: Feature vectors consisting of an intensity histogram and a SURF descriptor are first computed on a regular grid and then classified into the closest visual words to form a histogram. The vocabulary of visual words is a quantization of the feature space by offline clustering a large number of feature vectors from prototype volumes into visual words (or cluster centers) via the K-Means algorithm. For a set of prototype volumes whose body coordinates are known the slice descriptions are computed in advance. The body coordinates of a test volume are computed by a 1D rigid registration of the test volume with the prototype volumes in axial direction. The similarity of two slices is measured by comparing their histograms of visual words. Cross validation on a dataset of 44 volumes proved the robustness of the results. Even for test volumes of ca. 20cm height, the average error was 15.8mm. © 2009 Copyright SPIE - The International Society for Optical Engineering.

Etiological aspects of posterior epilepsies - Kasper, Burkhard; Roessler, Karl; Dörfler, Arnd (Zeitschrift für Epileptologie, 2020)
Background Posterior epilepsies (PE), i.e. focal epilepsies with epileptogenic zones within the posterior parts of the neocortical mantle (parietal, occipital and dorsal temporal lobes), represent a diagnostic and therapeutic challenge encompassing a wide spectrum of possible etiologies. Objective The etiological spectrum of PE is presented. Material and methods Illustration based on the longstanding personal expertise of the authors with examples of findings in personal cases. Results The PE is complex. Knowledge of the broad spectrum of possible etiologies is important in order to be able to reliably identify a PE including its etiology and to offer targeted treatment to selected patients. Successful epilepsy surgery is often possible.
CRIS-Team WoS Importer:2021-01-15

European Multicenter Study for the Evaluation of a Dual-Layer Flow-Diverting Stent for Treatment of Wide-Neck Intracranial Aneurysms: The European Flow-Redirection Intraluminal Device Study - Killer-Oberpfalzer, Monika; Kocer, N.; Griessenauer, C. J.; Janssen, H.; Engelhorn, Tobias; Holtmannspotter, Markus; Buhk, J. H.; Finkenzeller, Thomas; Fesl, G.; Trenkler, J.; Reith, W.; Berlis, A.; et al. (American Journal of Neuroradiology, 2018)
BACKGROUND AND PURPOSE: Endoluminal reconstruction with flow-diverting stents represents a widely accepted technique for the treatment of complex intracranial aneurysms. This European registry study analyzed the initial experience of 15 neurovascular centers with the Flow-Redirection Intraluminal Device (FRED) system. MATERIALS AND METHODS: Consecutive patients with intracranial aneurysms treated with the FRED between February 2012 and March 2015 were retrospectively reviewed. Complications and adverse events, transient and permanent morbidity, mortality, and occlusion rates were evaluated. RESULTS: During the defined study period, 579 aneurysms in 531 patients (median age, 54 years; range, 13-86 years) were treated with the FRED. Seven percent of patients were treated in the acute phase (≤3 days) of aneurysm rupture. The median aneurysm size was 7.6 mm (range, 1-36.6 mm), and the median neck size 4.5 mm (range, 1-30 mm). Angiographic follow-up of >3 months was available for 516 (89.1%) aneurysms. There was progressive occlusion witnessed with time, with complete occlusion in 18 (20%) aneurysms followed for up to 90 ± 14 days, 141 (82.5%) for 180 ± 20 days, 116 (91.3%) for 1 year ± 24 days, and 122 (95.3%) aneurysms followed for >1 year. Transient and permanent morbidity occurred in 3.2% and 0.8% of procedures, respectively. The overall mortality rate was 1.5%. CONCLUSIONS: This retrospective study in real-world patients demonstrated the safety and efficacy of the FRED for the treatment of intracranial aneurysms. In most cases, treatment with a single FRED resulted in complete angiographic occlusion at 1 year.
EVALuna2:34271

Evaluating the structural effects of intra-articular sprifermin on cartilage and non-cartilaginous tissue alterations, based on sqMRI assessment over 2 years - Roemer, Frank; Kraines, J.; Aydemir, A.; Wax, S.; Hochberg, M. C.; Crema, M. D.; Guermazi, A. (Osteoarthritis and Cartilage, 2020)
Objective: Sprifermin (recombinant human fibroblast growth factor-18), a potential disease-modifying osteoarthritis (OA) drug, demonstrated dose-dependent effects on femorotibial cartilage thickness (by quantitative magnetic resonance imaging [MRI]) in the phase II FORWARD study. This post-hoc analysis evaluated the potential effects of sprifermin on several articular structures in the whole joint over 24 months using semi-quantitative MRI assessment. Design: Patients aged 40–85 years with symptomatic radiographic knee OA, Kellgren–Lawrence grade 2 or 3, and medial minimum joint space width ≥2.5 mm in the target knee were randomized (1:1:1:1:1) to receive three double-blinded, once-weekly, intra-articular injections of sprifermin 30 μg or 100 μg or placebo every 6 (q6mo) or 12 months. 1.5- or 3 T MRIs were read using the Whole-Organ Magnetic Resonance Imaging Score (WORMS) system at baseline and 24 months. Change from baseline at 24 months on compartment and/or whole knee level was assessed for cartilage morphology, bone marrow lesions (BMLs), and osteophytes by delta-subregional and delta-sum (DSM) approaches. Menisci, Hoffa-synovitis, and effusion-synovitis were also evaluated for worsening. Results: 549 patients were included. Dose-dependent treatment effects from baseline to 24 months were observed on cartilage morphology (sprifermin 100 μg q6mo vs placebo; mean DSM (95% confidence interval [CI]) −0.6 (−1.5, 0.2); less cartilage worsening) in the entire knee and BMLs sprifermin 100 μg q6mo vs placebo; mean DSM (95% CI) −0.2 (−0.5, 0.1) in the patellofemoral compartment. No effects over 24 months were observed on osteophytes, menisci, Hoffa-synovitis or effusion-synovitis. Conclusions: Positive effects associated with sprifermin were observed for cartilage morphology changes, and BML improvement. There were no meaningful negative or positive effects associated with sprifermin in the other joint tissues examined.
CRIS-Team Scopus Importer:2020-08-28
Keywords: Knee; MRI; Sprifermin; Treatment; WORMS

Evaluation After Cochlear Implant Surgery: Correlation of Clinical Outcome and Imaging Findings using Flat-detector CT - Stock, Annika; Bozzato, Victoria; Kloska, Stephan; Bozzato, Alessandro; Hoppe, Ulrich; Hornung, Joachim; Dörfler, Arnd; Struffert, Tobias (Clinical Neuroradiology, 2020)
Purpose: Assessment of the cochlear implant (CI) electrode array position using flat-detector computed tomography (FDCT) to test dependence of postoperative outcome on intracochlear electrode position. Methods: A total of 102 patients implanted with 107 CIs underwent FDCT. Electrode position was rated as 1) scala tympani, 2) scala vestibuli, 3) scalar dislocation and 4) no deconvolution. Two independent neuroradiologists rated all image data sets twice and the scalar position was verified by a third neuroradiologist. Presurgical and postsurgical speech audiometry by the Freiburg monosyllabic test was used to evaluate auditory outcome after 6 months of speech rehabilitation. Results: Electrode array position was assessed by FDCT in 107 CIs. Of the electrodes 60 were detected in the scala tympani, 21 in the scala vestibuli, 24 electrode arrays showed scalar dislocation and 2 electrodes were not placed in an intracochlear position. There was no significant difference in rehabilitation outcomes between scala tympani and scala vestibuli inserted patients. Rehabilitation was also possible in patients with dislocated electrodes. Conclusion: The use of FDCT is a reliable diagnostic method to determine the position of the electrode array. In our study cohort, the electrode position had no significant impact on postoperative outcome except for non-deconvoluted electrode arrays.
CRIS-Team Scopus Importer:2020-06-26
Keywords: Cochlear implantation; Deafness; Dyna-CT; Misplaced cochlear implant electrode array; Rehabilitation

Evaluation of 2-point, 3-point, and 6-point Dixon magnetic resonance imaging with flexible echo timing for muscle fat quantification - Grimm, Alexandra; Meyer, Heiko; Nickel, Marcel D.; Nittka, Mathias; Raithel, Esther; Chaudry, Oliver; Friedberger, Andreas; Uder, Michael; Kemmler, Wolfgang; Quick, Harald H.; Engelke, Klaus (European Journal of Radiology, 2018)
The purpose of this study is to evaluate and compare 2-point (2pt), 3-point (3pt), and 6-point (6pt) Dixon magnetic resonance imaging (MRI) sequences with flexible echo times (TE) to measure proton density fat fraction (PDFF) within muscles. Two subject groups were recruited (G1: 23 young and healthy men, 31 ± 6 years; G2: 50 elderly men, sarcopenic, 77 ± 5 years). A 3-T MRI system was used to perform Dixon imaging on the left thigh. PDFF was measured with six Dixon prototype sequences: 2pt, 3pt, and 6pt sequences once with optimal TEs (in- and opposed-phase echo times), lower resolution, and higher bandwidth (optTE sequences) and once with higher image resolution (highRes sequences) and shortest possible TE, respectively. Intra-fascia PDFF content was determined. To evaluate the comparability among the sequences, Bland-Altman analysis was performed. The highRes 6pt Dixon sequences served as reference as a high correlation of this sequence to magnetic resonance spectroscopy has been shown before. The PDFF difference between the highRes 6pt Dixon sequence and the optTE 6pt, both 3pt, and the optTE 2pt was low (between 2.2% and 4.4%), however, not to the highRes 2pt Dixon sequence (33%). For the optTE sequences, difference decreased with the number of echoes used. In conclusion, for Dixon sequences with more than two echoes, the fat fraction measurement was reliable with arbitrary echo times, while for 2pt Dixon sequences, it was reliable with dedicated in- and opposed-phase echo timing.
EVALuna2:34695

Evaluation of a Marker Clip System in Sonographically Guided Core Needle Biopsy for Breast Cancer Localization Before and After Neoadjuvant Chemotherapy - Schulz-Wendtland, Rüdiger; Dankerl, P.; Bani, Mayada; Fasching, Peter; Heusinger, K.; Lux, Michael P.; Jud, Sebastian; Rauh, C.; Bayer, C. M.; Schrauder, M. G.; Beckmann, Matthias; Uder, M.; et al. (Geburtshilfe und Frauenheilkunde, 2017)
Introduction The placement of intramammary marker clips has proven to be helpful for tumor localization in patients undergoing neoadjuvant chemotherapy and breast-conserving surgery. The purpose of our study was to investigate the feasibility of using a clip marker system for breast cancer localization and its influence on the imaging assessment of treatment responses after neoadjuvant chemotherapy. Patients and Methods Between March and June 2015, a total of 25 patients (n = 25), with a suspicion of invasive breast cancer with diameters of at least 2 cm (cT2), underwent preoperative sonographically guided core needle biopsy using a single-use breast biopsy system (HistoCore(TM)) and intramammary clip marking using a directly adapted clip system based on the established O-Twist Marker(TM), before their scheduled preoperative neoadjuvant chemotherapy. Localization of the intramammary marker clip was controlled by sonography and digital breast tomosynthesis. Results Sonography detected no dislocation of intrammammary marker clips in 20 of 25 patients (80 %), while digital breast tomosynthesis showed accurate placement without dislocation in 24 patients (96 %) (p < 0.05). There was no evidence of significant clip migration during preoperative follow-up imaging after neoadjuvant chemotherapy. No complication related to the clip marking was noted and there was no difficulty in evaluating the treatment response to neoadjuvant chemotherapy. Among the breast-conserving surgeries performed, no cases were identified in which intraoperative loss of the marker clip had occurred. Conclusion Our study underscores the importance of intramammary marking clip systems before neoadjuvant chemotherapy. Placement of marker clips is advised to facilitate accurate tumor bed localization. With regard to digital breast tomosynthesis, its development continues to improve the quality of diagnostics and the therapy of breast cancer particularly for small breast cancer tumors or in neoadjuvant chemotherapy setting.
EVALuna2:14620

Evaluation of a metal artifact reduction algorithm applied to post-interventional flat detector CT in comparison to pre-treatment CT in patients with acute subarachnoid haemorrhage - Mennecke, Angelika; Svergun, Stanislav; Scholz, Bernhard; Royalty, Kevin; Dörfler, Arnd; Struffert, Tobias (European Radiology, 2017)
OBJECTIVES: Metal artefacts can impair accurate diagnosis of haemorrhage using flat detector CT (FD-CT), especially after aneurysm coiling. Within this work we evaluate a prototype metal artefact reduction algorithm by comparison of the artefact-reduced and the non-artefact-reduced FD-CT images to pre-treatment FD-CT and multi-slice CT images. METHODS: Twenty-five patients with acute aneurysmal subarachnoid haemorrhage (SAH) were selected retrospectively. FD-CT and multi-slice CT before endovascular treatment as well as FD-CT data sets after treatment were available for all patients. The algorithm was applied to post-treatment FD-CT. The effect of the algorithm was evaluated utilizing the pre-post concordance of a modified Fisher score, a subjective image quality assessment, the range of the Hounsfield units within three ROIs, and the pre-post slice-wise Pearson correlation. RESULTS: The pre-post concordance of the modified Fisher score, the subjective image quality, and the pre-post correlation of the ranges of the Hounsfield units were significantly higher for artefact-reduced than for non-artefact-reduced images. Within the metal-affected slices, the pre-post slice-wise Pearson correlation coefficient was higher for artefact-reduced than for non-artefact-reduced images. CONCLUSION: The overall diagnostic quality of the artefact-reduced images was improved and reached the level of the pre-interventional FD-CT images. The metal-unaffected parts of the image were not modified. KEY POINTS: • After coiling subarachnoid haemorrhage, metal artefacts seriously reduce FD-CT image quality. • This new metal artefact reduction algorithm is feasible for flat-detector CT. • After coiling, MAR is necessary for diagnostic quality of affected slices. • Slice-wise Pearson correlation is introduced to evaluate improvement of MAR in future studies. • Metal-unaffected parts of image are not modified by this MAR algorithm.
EVALuna2:33150

Evaluation of an Artificial Intelligence-Based 3D-Angiography for Visualization of Cerebral Vasculature - Lang, Stefan; Schmidt, Manuel; Eisenhut, Felix; Kaethner, Christian; Kowarschik, Markus; Lücking, Hannes; Dörfler, Arnd; Hölter, Philip (Clinical Neuroradiology, 2019)
Purpose: The three-dimensional digital subtraction angiography (3D DSA) technique is the current standard and is based on both mask and fill runs to enable the subtraction technique. Artificial intelligence (AI)-based 3D angiography (3DA) was developed to reduce radiation dosage because only one contrast-enhanced run of the C‑arm system is required for reconstruction of DSA-like 3D volumes. The aim was the evaluation of this algorithm regarding its diagnostic information. Methods: 3D DSA datasets without pathologic findings were reconstructed both with subtraction technique and with the AI-based algorithm. Corresponding reconstructions were evaluated by 2 neuroradiologists with respect to image quality (IQ), visualization of major segments of the circle of Willis (ICA = C4-C7; OphA; ACA = A1-A2, MCA = M1-M2; VA = V4; BA; AICA; SUCA; PCA = P1-P2), identifiability of perforators (lenticulostriate/thalamoperforating arteries) and vessel diameters (ICA = C4; MCA = M1; BA; PCA = P1). Results: In total 15 datasets were successfully reconstructed as 3D DSA and 3DA with diagnostic image quality. All major segments of the circle of Willis and perforators were comparably visualized with 3DA. Quantitative analysis of vessel diameters in 3D DSA and 3DA datasets was equivalent and did not show relevant differences (rICA = 0.901, p = 0.001; rM1 = 0.951, p = 0.001; rBA = 0.906, p = 0.001; rP1 = 0.991, p = 0.001). Conclusions: The use of 3DA demonstrated reliable visualization of cerebral vasculature with respect to quantitative and qualitative parameters. Therefore, 3DA is a promising method that might help to reduce patient radiation.
CRIS-Team Scopus Importer:2019-11-01
Keywords: 3D angiography; Artificial intelligence; Deep learning; Dose reduction; Flat-detector computed tomography

Evaluation of a novel content-based image retrieval system for the differentiation of interstitial lung diseases in CT examinations - Pogarell, Tobias; Bayerl, Nadine; Wetzl, Matthias; Roth, Jessica; Speier, Christoph; Uder, Michael; Dankerl, Peter; Cavallaro, Alexander Josef (Diagnostics, 2021)
To evaluate the reader’s diagnostic performance against the ground truth with and without the help of a novel content-based image retrieval system (CBIR) that retrieves images with similar CT patterns from a database of 79 different interstitial lung diseases. We evaluated three novice readers’ and three resident physicians‘ (with at least three years of experience) diagnostic performance evaluating 50 different CTs featuring 10 different patterns (e.g., honeycombing, tree-in bud, ground glass, bronchiectasis, etc.) and 24 different diseases (sarcoidosis, UIP, NSIP, Aspergillosis, COVID-19 pneumonia etc.). The participants read the cases first without assistance (and without feedback regarding correctness), and with a 2-month interval in a random order with the assistance of the novel CBIR. To invoke the CBIR, a ROI is placed into the pathologic pattern by the reader and the system retrieves diseases with similar patterns. To further narrow the differential diagnosis, the readers can consult an integrated textbook and have the possibility of selecting high-level semantic features representing clinical information (chronic, infectious, smoking status, etc.). We analyzed readers’ accuracy without and with CBIR assistance and further tested the hypothesis that the CBIR would help to improve diagnostic performance utilizing Wilcoxon signed rank test. The novice readers demonstrated an unassisted accuracy of 18/28/44%, and an assisted accuracy of 84/82/90%, respectively. The resident physicians demonstrated an unassisted accuracy of 56/56/70%, and an assisted accuracy of 94/90/96%, respectively. For each reader, as well as overall, Sign test demonstrated statistically significant (p < 0.01) difference between the unassisted and the assisted reads. For students and physicians, Chi2-test and Mann-Whitney-U test demonstrated statistically significant (p < 0.01) difference for unassisted reads and statistically insignificant (p > 0.01) difference for assisted reads. The evaluated CBIR relying on pattern analysis and featuring the option to filter the results of the CBIR by predominant characteristics of the diseases via selecting high-level semantic features helped to drastically improve novices’ and resident physicians’ accuracy in diagnosing interstitial lung diseases in CT.
CRIS-Team Scopus Importer:2021-12-03
Keywords: Computed tomography; Computer-aided diagnosis; Content-based image retrieval; Interstitial lung disease

Evaluation of Collaterals and Clot Burden Using Time-Resolved C-Arm Conebeam CT Angiography in the Angiography Suite: A Feasibility Study - Yang, P.; Niu, K.; Wu, Y.; Struffert, Tobias; Dörfler, Arnd; Holter, P.; Aagaard-Kienitz, Beverly; Strother, C.; Chen, G. -H. (American Journal of Neuroradiology, 2017)
BACKGROUND AND PURPOSE: The assessment of collaterals and clot burden in patients with acute ischemic stroke provides important information about treatment options and clinical outcome. Time-resolved C-arm conebeam CT angiography has the potential to provide accurate and reliable evaluations of collaterals and clot burden in the angiographic suite. Experience with this technique is extremely limited, and feasibility studies are needed to validate this technique. Our purpose was to present such a feasibility study. MATERIALS AND METHODS: Ten C-arm conebeam CT perfusion datasets from 10 subjects with acute ischemic stroke acquired before endovascular treatment were retrospectively processed to generate time-resolved conebeam CTA. From time-resolved conebeam CTA, 2 experienced readers evaluated the clot burden and collateral flow in consensus by using previously reported scoring systems and assessed the clinical value of this novel imaging technique independently. Interobserver agreement was analyzed by using the intraclass correlation analysis method. RESULTS: Clot burden and collateral flow can be assessed by using the commonly accepted scoring systems for all eligible cases. Additional clinical information (eg, the quantitative dynamic information of collateral flow) can be obtained from this new imaging technique. Two readers agreed that time-revolved C-arm conebeam CTA is the preferred method for evaluating the clot burden and collateral flow compared with other conventional imaging methods. CONCLUSIONS: Comprehensive evaluations of clot burden and collateral flow are feasible by using time-resolved C-arm conebeam CTA data acquired in the angiography suite. This technique further enriches the imaging tools in the angiography suite to enable a "one-stop- shop" imaging workflow for patients with acute ischemic stroke.
EVALuna2:33146

Evaluation of ct-guided ultra-low-dose protocol for injection guidance in preparation of mr-arthrography of the shoulder and hip joints in comparison to conventional and low-dose protocols - Goeller, Anja; Pogarell, Tobias; May, Matthias; Uder, Michael; Dankerl, Peter (Diagnostics, 2021)
To evaluate patients’ radiation exposure undergoing CT-guided joint injection in preparation of MR-arthrography. We developed a novel ultra-low-dose protocol utilizing tin-filtration, performed it in 60 patients and compared the radiation exposure (DLP) and success rate to conventional protocol (26 cases) and low-dose protocol (37 cases). We evaluated 123 patients’ radiation exposure undergoing CT-guided joint injection from 16 January–21 March. A total of 55 patients received CT-guided joint injections with various other examination protocols and were excluded from further investigation. In total, 56 patients received shoulder injection and 67 received hip injection with consecutive MR arthrography. The ultra-low-dose protocol was performed in 60 pa-tients, the low-dose protocol in 37 patients and the conventional protocol in 26 patients. We compared the dose of the interventional scans for each protocol (DLP) and then evaluated success rate with MR-arthrography images as gold standard of intraarticular or extracapsular contrast injection. There were significant differences when comparing the DLP of the ultra-low-dose protocol (DLP 1.1 ± 0.39; p < 0.01) to the low dose protocol (DLP 5.3 ± 3.24; p < 0.01) as well as against the conventional protocol (DLP 22.9 ± 8.66; p < 0.01). The ultra-low-dose protocol exposed the patients to an average effective dose of 0.016 millisievert and resulted in a successful joint injection in all 60 pa-tients. The low dose protocol as well as the conventional protocol were also successful in all patients. The presented ultra-low-dose CT-guided joint injection protocol for the preparation of MR-arthrog-raphy demonstrated to reduce patients’ radiation dose in a way that it was less than the equivalent of the natural radiation exposure in Germany over 3 days—and thereby, negligible to the patient.
CRIS-Team Scopus Importer:2021-10-22
Keywords: CT intervention; Joint injection; MR-arthrography; Radiation exposure; Radiation protection; Tin-filtration

Evaluation of finger A3 pulley rupture in the crimp grip position-a magnetic resonance imaging cadaver study - Bayer, Thomas; Adler, Werner; Schweizer, Andreas; Schoeffl, Isabelle; Uder, Michael; Janka, Rolf Matthias (Skeletal Radiology, 2015)
The correct diagnosis of an A3 pulley rupture is challenging for musculoskeletal radiologists. An A3 pulley rupture should in theory influence the shape of the proximal interphalangeal joint volar plate (VP) and the amount of bowstringing at level of the VP during finger flexion. The purpose of this study was to perform MRI with metric analysis of the VP configuration and VP bowstringing in cadaver fingers in the crimp grip position and to determine cut points for A3 pulley rupture.MRI in the crimp grip position was performed in 21 cadaver fingers with artificially created flexor tendon pulley tears (fingers with A3 pulley rupture n = 16, fingers without A3 pulley rupture n = 5). The distances of the translation of the VP relative to the middle phalanx base, the distances between the flexor tendons and the VP body, and the distances between the flexor tendon and bone (TB) were measured.Statistical analysis showed significantly lower VP translation distances and significantly higher VP tendon distances if the A3 pulley was ruptured. A2 TB and A4 TB distances did not differ significantly in specimens with and without A3 pulley rupture. The optimal cut points for A3 pulley rupture were a VP translation distance <2.8 mm and a VP tendon distance >1.4 mm.Reduction of the VP translation distance and augmentation of the VP tendon distance are suitable indirect signs of A3 pulley rupture.
EVALuna2:5492

Evaluation of finger cartilage composition in recreational climbers with 7 Tesla T2 mapping magnetic resonance imaging - Bayer, Thomas; Brockhoff, Marie-Jo; Nagel, Armin Michael; Adler, Werner; Lutter, Christoph; Janka, Rolf Matthias; Heiß, Rafael; Uder, Michael; Roemer, Frank (Frontiers in Sports and Active Living, 2023)
Purpose: Sport climbing may lead to tissue adaptation including finger cartilage before apparent surface damage is detectable. The main aim was to assess finger cartilage composition with T2 mapping in young, active climbers and to compare the results to a non-climbers' collective. A secondary aim was to compare whether differences in cartilage T2 times are observed between older vs. younger volunteers. Methods and materials: 7 Tesla MRI of the fingers Dig.2–4 was performed using a multi-echo spin echo sequence. Manual segmentation of 3 ROIs at the metacarpal heads, 1 ROI at the base phalanx and 1 ROI at the proximal interphalangeal joint was performed. Included were 13 volunteers without history of trauma who are regularly performing climbing activities as a recreational sport (>20 h/month). These were age-matched with 10 control subjects not performing climbing activities. Results: Mean age was 32.4 years for the climbing group and 25.8 years for the controls. Mean T2 values for the 5 different ROIs were 42.2 ± 7.8 msec for climbers and 41.4 ± 6.8 msec for non-climbers. No significant differences were observed for T2 values between both groups. However, higher age had a significant impact on T2 values for all assessed ROIs (higher age 44.2 ± 9.5, younger age 32.9 ± 5.7, p = 0.001). Discussion: This study evaluated the cartilage composition of young, engaged climbers with a T2 mapping MRI technique with the purpose to depict early onset joint changes. No negative impact on cartilage composition due to the sport activity was found, whereas age-related effects on the cartilage seemed to be more prominent.
CRIS-Team Scopus Importer:2023-10-20
Keywords: cartilage; climbing; finger; magenetic resonance imaging; mapping

Evaluation of Functional Recovery Following Thrombectomy in Patients With Large Vessel Occlusion and Prestroke Disability - Sprügel, Maximilian; Sembill, Jochen; Kremer, Svenja; Gerner, Stefan; Knott, Michael; Hock, Stefan; Engelhorn, Tobias; Dörfler, Arnd; Huttner, Hagen; Schwab, Stefan (JAMA Network Open, 2022)
IMPORTANCE It is uncertain whether thrombectomy is associated with benefits in patients with prestroke disability.
CRIS-Team WoS Importer:2022-09-02

Evaluation of newly adapted clip marker system in ultrasound-guided core needle biopsy for suspicion of breast cancer - Schulz-Wendtland, Rüdiger; Dankerl, Peter; Dilbat, G.; Bani, Mayada; Fasching, Peter; Heusinger, K.; Lux, Michael P.; Löhberg, Christian; Jud, Sebastian; Rauh, Claudia; Bayer, Christian M.; Beckmann, Matthias; et al. (Geburtshilfe und Frauenheilkunde, 2013)
Introduction: A newly adapted clip system for intramammary marking during ultrasound-guided core needle biopsy for suspicion of breast cancer is described and evaluated here. Material and Method: Fifty patients with suspicion of breast cancer (cT2) had ultrasound-guided core needle biopsy using a newly adapted clip marker system (HistoCore™ and O-Twist Marker™). Subsequently, ultrasound follow-up and tomosynthesis scans were done to determine the location of the marker clips. Results: No dislocation of the marker clip was detected on ultrasound in 45 of 50 patients (90%), and 5 patients (10%) had a maximum dislocation of 5 mm along the x-, y- or z-axis. Tomosynthesis scans demonstrated precise placement without dislocation of the clip markers in 48 patients (96%); 2 patients (4%) had a maximum dislocation of 3 mm along the x-, y- or z-axis. Conclusion: The newly developed clip marker system, a combination of a single-use breast biopsy needle and a precise, length-adapted intramammary marker clip, represents a further improvement in oncological therapy. This is of particular importance for patients requiring subsequent neoadjuvant chemotherapy, as in cases with complete tumour remission, there is no target point for preoperative, ultrasound-guided wire marking. © Georg Thieme Verlag KG Stuttgart New York.
CRIS-Team Scopus Importer:2023-03-08
Keywords: biopsy; breast; breast cancer; ultrasound

Evaluation of novice reader diagnostic performance in coronary CT angiography using an advanced cardiac software package - Dankerl, Peter; Hammon, Matthias; Tsymbal, Alexey; Achenbach, Stephan; Uder, Michael; Janka, Rolf Matthias; Cavallaro, Alexander Josef (International Journal of Computer Assisted Radiology and Surgery, 2014)
The purpose of this research was to evaluate whether a commercially available advanced cardiac software package for coronary CT angiography (CTA) interpretation may reliably assist inexperienced readers to screen for significant coronary artery stenoses.Coronary CTA data sets of 61 consecutive patients with suspected coronary artery disease were evaluated by three novice readers with no experience in cardiac CT interpretation. In the first 15 patients, the novice readers were trained to use the advanced cardiac software package (includes automatic detection of coronary vessels, curved MPR and VRT reconstructions and a measurement too) knowing the results of an expert read. In the next 46 patients, the novice readers had to state whether there is a significant coronary artery stenosis ([Formula: see text]50 %) and if they are confident with their diagnosis. The results of the novice readers were compared to the expert read.The 46 coronary CTA data sets contained 184 vessels with 15 stenoses in 9 patients. On a per-vessel analysis, novice reader 1/2/3 demonstrated 60 %/100 %/ 93% sensitivity, and 98 %/90 %/86 % specificity. Per patient, the readers diagnosed 36/28/29 cases correctly as free of stenoses, 6/9/8 correctly as having at least one stenosis, missed 3/0/1 cases with a stenosis and overdiagnosed 1/9/8 patients. Cohen's kappa values for the three readers versus the expert were 0.60, 0.61 and 0.54. The three novice readers felt confident in the diagnosis of 36/33/30 patients. In these patients, they missed one significant stenosis, showed a sensitivity of 100 %/100 %/75 % and a specificity of 100 %/92 %/88 %.The evaluated advanced cardiac software package successfully assists novice readers in interpreting coronary CTA data sets especially in ruling out significant coronary artery stenosis.
EVALuna2:11866

Evaluation of Rib Fractures on a Single-in-plane Image Reformation of the Rib Cage in CT Examinations - Dankerl, Peter; Seuß, Hannes; Ellmann, Stephan; Uder, Michael; Hammon, Matthias; Cavallaro, Alexander Josef (Academic Radiology, 2016)
This study aimed to evaluate the diagnostic performance of using a reformatted single-in-plane image reformation of the rib cage for the detection of rib fractures in computed tomography (CT) examinations, employing different levels of radiological experience.We retrospectively evaluated 10 consecutive patients with and 10 patients without rib fractures, whose CT scans were reformatted to a single-in-plane image reformation of the rib cage. Eight readers (two radiologists, two residents in radiology, and four interns) independently evaluated the images for the presence of rib fractures using a reformatted single-in-plane image and a multi-planar image reformation. The time limit was 30 seconds for each read. A consensus of two radiologist readings was considered as the reference standard. Diagnostic performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) was assessed and evaluated per rib and per location (anterior, lateral, posterior). To determine the time limit, we prospectively analyzed the average time it took radiologists to assess the rib cage, in a bone window setting, in 50 routine CT examinations. McNemar test was used to compare the diagnostic performances.Single image reformation was successful in all 20 patients. The sensitivity, specificity, PPV, and NPV for the detection of rib fractures using the conventional multi-planar read were 77.5%, 99.2%, 89.9%, and 98.0% for radiologists; 46.3%, 99.7%, 92.5%, and 95.3% for residents; and 29.4%, 99.4%, 82.5%, and 93.9% for interns, respectively. Sensitivity, PPV, and NPV increased across all three groups of experience, using the reformatted single-in-plane image of the rib cage (radiologists: 85.0%, 98.6%, and 98.7%; residents: 80.0%, 92.8%, and 98.2%; interns: 66.9%, 89.9%, and 97.1%), whereas specificity did not change significantly (99.9%, 99.4%, and 99.3%). The diagnostic performance of the interns and residents was significantly better when evaluating the single-in-plane image reformations (P < .01). The diagnostic performance of the radiologists was better when evaluating the single-in-plane image reformations; however, there was no significant difference (statistical power: 0.32).The diagnostic performance for the detection of rib fractures, using CT images that have been reformatted to a single-in-plane image, improves for readers from different educational levels when the evaluation time is restricted to 30 seconds or less.
EVALuna2:14593

Evaluation of Sodium Relaxation Times and Concentrations in the Achilles Tendon Using MRI - Kamp, Benedikt; Frenken, Miriam; Klein-Schmeink, Lena; Nagel, Armin Michael; Wilms, Lena M.; Radke, Karl Ludger; Tsiami, Styliani; Sewerin, Philipp; Baraliakos, Xenofon; Antoch, Gerald; Abrar, Daniel B.; Wittsack, Hans-Joerg; et al. (International Journal of Molecular Sciences, 2022)
Sodium magnetic resonance imaging (MRI) can be used to evaluate the change in the proteoglycan content in Achilles tendons (ATs) of patients with different AT pathologies by measuring the 23Na signal-to-noise ratio (SNR). As 23Na SNR alone is difficult to compare between different studies, because of the high influence of hardware configurations and sequence settings on the SNR, we further set out to measure the apparent tissue sodium content (aTSC) in the AT as a better comparable parameter. Ten healthy controls and one patient with tendinopathy in the AT were examined using a clinical 3 Tesla (T) MRI scanner in conjunction with a dual tuned 1H/23Na surface coil to measure 23Na SNR and aTSC in their ATs. 23Na T1 and T2* of the AT were also measured for three controls to correct for different relaxation behavior. The results were as follows: 23Na SNR = 11.7 ± 2.2, aTSC = 82.2 ± 13.9 mM, 23Na T1 = 20.4 ± 2.4 ms, 23Na T2s* = 1.4 ± 0.4 ms, and 23Na T2l* = 13.9 ± 0.8 ms for the whole AT of healthy controls with significant regional differences. These are the first reported aTSCs and 23Na relaxation times for the AT using sodium MRI and may serve for future comparability in different studies regarding examinations of diseased ATs with sodium MRI.
CRIS-Team Scopus Importer:2022-10-07
Keywords: 23Na MRI; Achilles tendon; collagen; glycosaminoglycan; proteoglycan; sodium concentration; sodium MRI; sodium relaxation time; tendon

Evaluation of spine MRIs in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games - Wasserman, Michael S.; Guermazi, Ali; Jarraya, Mohamed; Engbretsen, Lars; Abdelkader, Mohamad; Roemer, Frank; Hayashi, Daichi; Crema, Michel D.; Mian, Asim Z. (BMJ Open Sport and Exercise Medicine, 2018)
Background/aim: In high-level Olympic athletes, many spinal pathologies arise from overuse, while others are the result of acute injury. Our aim is to analyse the epidemiology of spinal pathologies detected on MRI in athletes participating in the 2016 Rio de Janeiro Summer Olympics. Methods: In this retrospective study, all spine MRIs performed during the 2016 Rio Games were analysed. Descriptive data from the MRIs were tabulated and analysed for disc degeneration, spinal canal and/or neural foraminal narrowing, and acute/chronic fractures. Data were analysed by sport, continent of origin, age and sex. Results: Of 11 274 athletes participating in the Olympic games, 100 received spine MRI. Fifty-two of the 100 (52%) athletes who received cervical, thoracic and/or lumbar spine MRI showed moderate to severe spinal disease. The highest sport-specific incidence of moderate to severe spine disease was seen in aquatic diving athletes (67%, 3 per 100 divers). Weightlifting had the second highest sport-specific incidence of spine disease (67%, 1.5 per 100 weightlifters). Athletics used the most spine MRIs (31 of 107 MRIs, 29%). European athletes had more spine MRIs than all other continents combined (55 of 107 MRIs, 51%). Athletes over 30 years old had the highest rate of moderate to severe spine disease on MRI (24 of 37 athletes >30 years old, 65%). Conclusions: A high number of the world's premier athletes demonstrated moderate to severe spine disease on MRI during the 2016 Summer Olympics, including moderate/severe degenerative disc changes with varying degrees of disc bulges and herniations.
EVALuna2:35362

Evaluation of the influence of susceptibility-induced magnetic field distortions on the precision of contouring intracranial organs at risk for stereotactic radiosurgery - Mengling, Veit; Putz, Florian; Laun, Frederik Bernd; Perrin, Rosalind; Eisenhut, Felix; Dörfler, Arnd; Fietkau, Rainer; Bert, Christoph (Physics and Imaging in Radiation Oncology, 2020)
Background and purpose: Magnetic resonance imaging (MRI) is a crucial factor in optimal treatment planning for stereotactic radiosurgery. To further the awareness of possible errors in MRI, this work aimed to investigate the magnitude of susceptibility induced MRI distortions for intracranial organs at risk (OARs) and test the effectiveness of actively shimming these distortions. Materials and methods: Distortion maps for 45 exams of 42 patients (18 on a 1.5 T MRI scanner, 27 on a 3 T MRI scanner) were calculated based on a high-bandwidth double-echo gradient echo sequence. The investigated OARs were brainstem, chiasm, eyes, and optic nerves. The influence of active shimming was investigated by comparing unshimmed 1.5 T data with shimmed 3 T data and comparing the results to a model based prediction. Results: The median distortion for the different OARs was found to be between 0.13 and 0.18 mm for 1.5 T and between 0.11 and 0.13 mm for 3 T. The maximum distortion was found to be between 1.3 and 1.7 mm for 1.5 T and between 1.1 and 1.4 mm for 3 T. The variation of values was much higher for 1.5 T than for 3 T across all investigated OARs. Active shimming was found to reduce distortions by a factor of 2.3 to 2.9 compared to the expected values. Conclusions: Using a safety margin for OARs of 1 mm would have encompassed 99.8% of the distortions. Since distortions are inversely proportional to the readout bandwidth, they can be further reduced by increasing the bandwidth. Additional error sources like gradient nonlinearities need to be addressed separately.
CRIS-Team Scopus Importer:2020-08-21
Keywords: Brain; MRI; PRV; Safety margins; Stereotactic; Susceptibility artifacts

Evaluation of ventricular septal defects using high pitch computed tomography angiography of the chest in children with complex congenital heart defects below one year of age - Nau, David; Wüst, Wolfgang; Rompel, Oliver; Hammon, Matthias; Glöckler, Martin; Toka, Okan; Dittrich, Sven; Rueffer, André; Cesnjevar, Robert; Lell, Michael M.; Uder, Michael; May, Matthias (Journal of Cardiovascular Computed Tomography, 2019)
Background: Aim of this study was to assess the accuracy of ventricular septal defects (VSD) using high pitch computed tomography angiography (CTA) of the chest in children below 1 year of age, compared to the intraoperative findings and echocardiography. Methods: Out of 154 patients that underwent Dual-Source CTA of the chest using a high-pitch protocol at low tube voltages (70–80 kV), 55 underwent surgical repair of a VSD (median age 8 days, range 1–348 days). The margins of the VSDs and their relation to the surrounding structures were reproduced by en-face views using multiplanar reformations (MPR). Absolute diameter, normalized area and relative area compared to the aortic valve annulus were used for discrimination between restrictive and non-restrictive defects. Localization was classified into four subtypes. The results were compared to two-dimensional echocardiography and intraoperative findings. Results: Median absolute size of VSDs did not differ significantly between CTA-measurements (10.8 mm, range 2.8–18.1 mm) and intraoperative findings (12.0 mm, 3.0–25.0 mm, p = 0.09). Echocardiographic values were significantly lower (9.6 mm, 3.0–18.5 mm, both p < 0.01). The classification of the location and orientation matched the intraoperative situs in 96.4% of all cases using CT and in 87.3% using echocardiography. Echocardiography missed the relation to valves in 11% of all cases. Pre-interventional sensitivity and specificity for detection of a VSD were 97.2/98.9% compared to echocardiography. Median radiation dose was 0.32 mSv (range 0.12–2.00 mSv) and differed significantly between second and third generation Dual-Source CT (0.43 vs. 0.22 mSv, p = 0.003). Conclusion: Size and subtype of VSDs can be accurately assessed by CTA of the chest in patients with complex congenital heart defects at a very low radiation dose.
CRIS-Team Scopus Importer:2019-10-22
Keywords: Computed tomography angiography; Congenital heart defect; Dual-source; High pitch; Ventricular septal defect

Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with ("pseudo-randomized") treatment allocation by the health insurance provider - Hofmann, Susanne; Schmidt, Manuel; Weissmann, Thomas; Eyüpoglu, Ilker Yasin; Strnad, Annedore; Semrau, Sabine; Fietkau, Rainer; Putz, Florian; Lettmaier, Sebastian (Journal of Neuro-Oncology, 2020)
Introduction Despite a large number of trials, the role of bevacizumab (BEV) in the treatment of recurrent high-grade gliomas is still controversial. Evidence regarding an effect on overall survival in this context is ultimately inconclusive. At the Department of Radiation Oncology at Erlangen, Germany we treated a large cohort of patients with recurrent gliomas where bevacizumab use was determined exclusively by the health care provider's approval of reimbursement. Methods 61 patients (between 06/2008 and 01/2014) with recurrent high-grade gliomas had reimbursement requests for BEV sent to their health insurance. 37 patients out of 61 (60.7%) had their requests approved and therefore received bevacizumab (BEV-arm) as part of their treatment. The remaining 24 (39.3%) patients received standard therapy without bevacizumab (non-BEV-arm). Survival endpoints were defined with reference to the first BEV request to the health insurance provider. Results Median overall survival (OS) for the whole cohort was 7.0 months. OS was significantly better for BEV vs. Non-BEV patients (median, 10.3 vs. 4.2 months, logrank p = 0.023). There was an increased BEV benefit in cases of higher-order recurrences (first order recurrence BEV vs. Non-BEV, 12.5 vs. 10.2 months, p = 0.578) (second or higher order of recurrence, 9.9 vs. 2.6 months, p = 0.010). On multivariate analysis for overall survival the prognostic impact of bevacizumab (HR = 0.43, p = 0.034) remained significant. Conclusion Our results suggest an influence of BEV on overall survival in a heavily pretreated patient population suffering from high-grade gliomas with BEV benefit being greatest in case of second or later recurrence.
CRIS-Team WoS Importer:2020-05-29

Evidence of ACL healing on MRI following ACL rupture treated with rehabilitation alone may be associated with better patient-reported outcomes: a secondary analysis from the KANON trial - Filbay, Stephanie Rose; Roemer, Frank; Lohmander, L. Stefan; Turkiewicz, Aleksandra; Roos, Ewa M.; Frobell, Richard; Englund, Martin (British Journal of Sports Medicine, 2022)
Objectives Evaluate the natural course of anterior cruciate ligament (ACL) healing on MRI within 5 years of acute ACL rupture and compare 2-year and 5-year outcomes based on healing status and treatment group. Methods Secondary analysis of 120 Knee Anterior Cruciate Ligament Nonsurgical vs Surgical Treatment (KANON) trial participants randomised to rehabilitation and optional delayed ACL reconstruction (ACLR) or early ACLR and rehabilitation. ACL continuity on MRI (Anterior Cruciate Ligament OsteoArthritis Score 0-2) was considered evidence of ACL healing. Outcomes included Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS patient acceptable symptomatic state (PASS) and treatment failure criteria. Linear mixed models were used to estimate adjusted mean differences (95% CIs) in patient-reported sport and recreational function (KOOS-Sport/Rec) and quality of life (KOOS-QOL) at 2 and 5 years, between participants with MRI evidence of ACL healing and those who had (1) no evidence of ACL healing, (2) delayed ACLR or (3) early ACLR. Results MRI evidence of ACL healing at 2-year follow-up was observed in 16 of 54 (30%, 95% CI 19 to 43%) participants randomised to optional delayed ACLR. Excluding participants who had delayed ACLR, 16 of 30 (53%, 36-70%) participants managed with rehabilitation-alone displayed MRI evidence of ACL healing. Two-year outcomes were better in the healed ACL group (n=16) compared with the non-healed (n=14) (mean difference (95% CI) KOOS-Sport/Rec: 25.1 (8.6-41.5); KOOS-QOL: 27.5 (13.2-41.8)), delayed ACLR (n=24) (KOOS-Sport/Rec: 24.9 (10.2-39.6); KOOS-QOL: 18.1 (5.4-30.8)) and early ACLR (n=62) (KOOS-Sport/Rec: 17.4 (4.1-30.7); KOOS-QOL: 11.4 (0.0-22.9)) groups. Five-year KOOS-QOL was better in the healed versus non-healed group (25.3 (9.4-41.2)). Of participants with MRI evidence of ACL healing, 63-94% met the PASS criteria for each KOOS subscale, compared with 29-61% in the non-healed or reconstructed groups. Conclusions MRI appearance of ACL healing after ACL rupture occurred in one in three adults randomised to initial rehabilitation and one in two who did not cross-over to delayed ACLR and was associated with favourable outcomes. The potential for spontaneous healing of the ACL to facilitate better clinical outcomes may be greater than previously considered.
CRIS-Team WoS Importer:2022-11-25

Evidence that meniscus damage may be a component of osteoarthritis: the Framingham study - Englund, Martin; Haugen, I. K.; Guermazi, Ali; Roemer, Frank; Niu, J.; Neogi, T.; Aliabadi, P.; Felson, D. T. (Osteoarthritis and Cartilage, 2016)
The etiology of degenerative meniscus tear is unclear but could be related to a generalized osteoarthritic disease process. We studied whether radiographic hand osteoarthritis (OA) is associated with meniscus damage.We examined 974 persons aged 50-90 years drawn via census tract data and random-digit dialing from Framingham, Massachusetts, United States. One reader assessed bilateral hand radiographs (30 joints) and another read frontal knee radiographs, all according to the Kellgren-Lawrence (KL) scale. A third reader assessed right knee 1.5-T magnetic resonance imaging (MRI) scans for meniscus damage. We calculated the prevalence of medial and/or lateral meniscus damage in those with one to two and three or more finger joints with radiographic OA (KL grade >=2) compared to those without radiographic hand OA with adjustment for age, sex, and body mass index. We also evaluated the above association in persons without evidence of radiographic OA (KL grade 0) in their knee (n = 748).The prevalence of meniscus damage in the knee of subjects with no, one to two, and three or more finger joints with OA was 24.9%, 31.7%, and 47.2%, respectively. The adjusted prevalence ratio (PR) of having meniscus damage was significantly increased in those who had three or more finger joints with OA (1.40 [95% confidence interval (CI) 1.11-1.77]). The estimate remained similar in persons without evidence of radiographic OA in their knee (PR, 1.42 [95% CI 1.03-1.97]). The association was more robust for medial meniscus damage.Results suggest a common non-age related etiologic pathway for both radiographic hand OA and meniscus damage.
EVALuna2:14472

Evidenzbasierte und strukturierte Diagnostik in der MR-Mammografie anhand des Kaiser-Score - Baltzer, Pascal Andreas Thomas; Krug, Kathrin Barbara; Dietzel, Matthias (TumorDiagnostik & Therapie, 2023)
Background Breast MRI is the most sensitive method for the detection of breast cancer and is an integral part of modern breast imaging. On the other hand, interpretation of breast MRI exams is considered challenging due to the complexity of the available information. Clinical decision rules that combine diagnostic criteria in an algorithm can help the radiologist to read breast MRI by supporting objective and largely experience-independent diagnosis. Method Narrative review. In this article, the Kaiser Score (KS) as a clinical decision rule for breast MRI is introduced, its diagnostic criteria are defined, and strategies for clinical decision making using the KS are explained and discussed. Results The KS is based on machine learning and has been independently validated by international research. It is largely independent of the examination technique that is used. It allows objective differentiation between benign and malignant contrast-enhancing breast MRI findings using diagnostic BI-RADS criteria taken from T2w and dynamic contrast-enhanced T1w images. A flowchart guides the reader in up to three steps to determine a score corresponding to the probability of malignancy that can be used to assign a BI-RADS category. Individual decision making takes the clinical context into account and is illustrated by typical scenarios. Key Points: The KS as an evidence-based decision rule to objectively distinguish benign from malignant breast lesions is based on information contained in T2w und dynamic contrast-enhanced T1w sequences and is largely independent of specific examination protocols. The KS diagnostic criteria are in line with the MRI BI-RADS lexicon. We focused on defining a default category to be applied in the case of equivocal imaging criteria. The KS reflects increasing probabilities of malignancy and, together with the clinical context, assists individual decision making. Citation Format Baltzer PA, Krug KB, Dietzel M. Evidence-Based and Structured Diagnosis in Breast MRI using the Kaiser Score. Fortschr Röntgenstr 2022; 194: 1216-1228.
CRIS-Team Scopus Importer:2023-03-24
Keywords: biopsy; breast; decision analysis; MR imaging

Exercise and fracture prevention. Recommendations on types of exercise for bone strengthening - Willert, Sebastian; von Stengel, Simon; Kohl, Matthias; Jakob, Franz; Kerschan-Schindl, Katharina; Lange, Uwe; Peters, Stefan; Thomasius, Friederike; Kemmler, Wolfgang (Osteologie, 2023)
In basic exercise science, training contents characterize the types of exercise needed to address the training aim. The usual classification of exercise contents into endurance, resistance or coordination exercise is hardly applicable for bone, however. As an example, endurance exercise includes various types of exercise that considerably vary in their mechanical demands (e. g. running vs. swimming). Following a more bone-specific approach, a classification of training contents into three site-specific, mechanical bone factors and one systemic endocrine factor is more appropriate. Applying bone factors, i. e. axial loading, muscular tension, load distribution and endocrine effect of exercise, enables the relevance of different sports for bone strength to be judged by analyzing their inherent exercise characteristic. Many cross-sectional studies focus on highly trained athletes because of the high training compliance and the long exercise exposure in this cohort. As confirmed by longitudinal exercise trials with older adults, the study results indicate that types of exercise with high demands on axial loading, muscular tension and load distribution, which in turn generate a favorable hormonal milieu, are particularly effective in increasing bone-strength parameters. Dynamic resistance exercise (DRT) or exercises with high impact (e. g. exercises with jumping or sprinting components) largely offer such favorable exercise characteristics. However, the physical status and safety aspects related to the predominately older cohorts prone to osteoporosis frequently conflict with the application of high-impact exercise. On the other hand, current evidence suggests that even high intensity DRT can be applied safely and pain-free in older cohorts with osteoarthritis. For particularly vulnerable cohorts, aquatic gymnastics can be recommended for increasing bone mineral density at the lumbar spine and proximal femur. As a sustainable vehicle for implementing exercise, consistently supervised "Rehabilitationssport" or "Funktionstraining" can be recommended as a feasible and widespread training option for fracture prevention.
CRIS-Team WoS Importer:2023-06-02

Exercise and the prevention of major osteoporotic fractures in adults: a systematic review and meta-analysis with special emphasis on intensity progression and study duration - Hoffmann, Isabelle; Kohl, Matthias; von Stengel, Simon; Jakob, Franz; Kerschan-Schindl, Katharina; Lange, Uwe; Peters, Stefan; Schöne, Daniel; Sieber, Cornel; Thomasius, Friederike; Bischoff-Ferrari, Heike A.; Uder, Michael; et al. (Osteoporosis international, 2022)
The role of exercise in preventing osteoporotic fractures is vague, and further recommendations for optimized exercise protocols are very rare. In the present work, we provided positive evidence for exercise effects on the number of osteoporotic fractures in adults, albeit without observing any significant relevance of intensity progression or study duration. Introduction Osteoporotic fractures are a major challenge confronting our aging society. Exercise might be an efficient agent for reducing osteoporotic fractures in older adults, but the most promising exercise protocol for that purpose has yet to be identified. The present meta-analysis thus aimed to identify important predictors of the exercise effect on osteoporotic fractures in adults. Methods We conducted a systematic search of six literature databases according to the PRISMA guideline that included controlled exercise studies and reported the number of low-trauma major osteoporotic fractures separately for exercise (EG) and control (CG) groups. Primary study outcome was incidence ratio (IR) for major osteoporotic fractures. Sub-analyses were conducted for progression of intensity (yes vs. no) during the trial and the study duration (<= 12 months vs. > 12 months). Results In summary, 11 studies with a pooled number of 9715 participant-years in the EG and 9592 in the CG were included. The mixed-effects conditional Poisson regression revealed positive exercise effects on major osteoporotic fractures (RR: 0.75, 95% CI: 0.54-0.94, p = .006). Although studies with intensity progression were more favorable, our subgroup analysis did not determine significant differences for diverging intensity progression (p = .133) or study duration (p = .883). Heterogeneity among the trials of the subgroups (I-2 <= 0-7.1%) was negligible. Conclusion The present systematic review and meta-analysis provided significant evidence for the favorable effect of exercise on major osteoporotic fractures. However, diverging study and exercise characteristics along with the close interaction of exercise parameters prevented the derivation of reliable recommendations for exercise protocols for fracture reductions. PROSPERO ID: CRD42021250467.
CRIS-Team WoS Importer:2022-12-02

Exercise Dependent Changes in Periosteal Femur Perfusion - Schroeter, S.; Rueter, L.; Heiß, Rafael; Hammer, Christian; Lutter, C.; Hoppe, M. W.; Grim, C.; Engelhardt, M.; Hotfiel, T. (Sport-Orthopädie, Sport-Traumatologie, 2022)
Background: Contrast-enhanced ultrasound (CEUS) has been shown to be a valid measurement tool for evaluating microvascular blood flow. Until now, the assessment of periosteal tissue has been insufficiently validated, and a procedure has not yet been standardized for this purpose. The aim of the present study was to investigate periosteal femur perfusion in the context of cycling exercise by means of CEUS and to evaluate the feasibility and reliability of this method. Material and Methods: Seventeen healthy athletes were recruited as study participants for the evaluation of periosteal femur perfusion (FP) and vastus intermedius muscle (VI) by CEUS (bolus dosage of 2.7 ml contrast agent, Sonovue, Bracco, Italy). Data were acquired from participants under resting conditions (T0) and immediately after standardized cycling exercise (T1, 20 min, 70% of maximum capacity). Peak enhancement (PE), the wash-in rate (WiR), the wash-in area under the curve (WiAUC), and the wash-in perfusion index (WiPI) were determined by software-based mapping quantification (Vuebox, Bracco, Italy). Intra- and interrater reliability were assessed among three different measurement time points and two investigators. Results: After exercise, a significant perfusion increase in the femur periosteum of 101.8% (PE; p = 0.003), 176.7% (WiR; p = 0.02), 93% (WiAUC; p< 0.001) and 116.2% (WiPI; p< 0.001) was observed in all measurement parameters compared to the resting conditions. For the VI, the increase was 110.9% (PE; p = 0.003), 221.3% (WiR; p< 0.001), 49.1% (WiAUC; p = 0.03), and 120.4% (WiPI; p< 0.001). Intrarater reliability showed measurement errors of 3.2–3.4% (PE), 5.0–5.1% (WiR), 4.5–4.1% (WiAUC), and 4.5–6.1% (WiPI). Interrater reliability presented measurement errors that ranged from 5.0–7.0% for T0 and 3.3–5.5% for T1. Conclusions: Lower limb exercise with a moderate load (ergometer cycling) significantly enhanced perfusion in healthy athletes within the FP and VI. Our data support the implementation of moderate exercise if enhanced tissue circulation is required. The findings from this study show that performing CEUS on the FP is a valuable diagnostic modality with high intra- and interrater reliability.
CRIS-Team Scopus Importer:2022-04-01
Keywords: Bone metabolism; CEUS; Contrast-enhanced ultrasound; Femur; Microcirculation; Periosteal perfusion

Exercise effects on bone mineral density in men - Mages, Michelle; Shojaa, Mahdieh; Kohl, Matthias; von Stengel, Simon; Becker, Clemens; Gosch, Markus; Jakob, Franz; Kerschan-Schindl, Katharina; Kladny, Bernd; Klöckner, Nicole; Lange, Uwe; Middeldorf, Stefan; et al. (Nutrients, 2021)
In contrast to postmenopausal women, evidence for a favorable effect of exercise on Bone Mineral Density (BMD) is still limited for men. This might be due to the paucity of studies, but also to the great variety of participants and study characteristics that may dilute study results. The aim of the present systematic review and meta-analysis was to evaluate the effect of exercise on BMD changes with rational eligibility criteria. A comprehensive search of six electronic databases up to 15 March 2021 was conducted. Briefly, controlled trials ≥6 months that determined changes in areal BMD in men >18 years old, with no apparent diseases or pharmacological therapy that relevantly affect bone metabolism, were included. BMD changes (standardized mean differences: SMD) of the lumbar spine (LS) and femoral neck (FN) were considered as outcomes. Twelve studies with 16 exercise and 12 control groups were identified. The pooled estimate of random-effect analysis was SMD = 0.38, 95%-CI: 0.14–0.61 and SMD = 0.25, 95%-CI: 0.00–0.49, for LS and FN, respectively. Heterogeneity between the trials was low–moderate. Funnel plots and rank and regression correlation tests indicate evidence for small study publication bias for LS but not FN-BMD. Subgroup analyses that focus on study length, type of exercise and methodologic quality revealed no significant difference between each of the three categories. In summary, we provided further evidence for a low but significant effect of exercise on BMD in men. However, we are currently unable to give even rough exercise recommendations for male cohorts.
CRIS-Team Scopus Importer:2021-12-17
Keywords: Bone mineral density; Exercise; Men; Overview

Exercise effects on glucocorticoid-induced bone loss in adults: a systematic review and meta-analysis - Kast, Stephanie; Jakob, Franz; Kohl, Matthias; von Stengel, Simon; Kerschan-Schindl, Katharina; Lange, Uwe; Thomasius, Friederike; Kemmler, Wolfgang (Rheumatology Advances in Practice, 2022)
Objectives Due to their pronounced anti-inflammatory and immunosuppressive effects, glucocorticoids (GCs) are widely used in inflammatory conditions and organ transplants. Unfortunately, GC-induced osteoporosis is one of the most common causes of secondary osteoporosis. The aim of the present systematic review and meta-analysis was to determine the effect of exercise added to GC therapy on BMD at the lumbar spine or femoral neck in people on GC therapy. Methods A systematic literature search of five electronic databases included controlled trials with a duration of >6 months and at least two study arms [glucocorticoids (GCs) and GCs and exercise (GC + EX)] were conducted up to 20 September 2022. Studies involving other pharmaceutical therapies with relevant effects on bone metabolism were excluded. We applied the inverse heterogeneity model. Outcome measures were standardized mean differences (SMDs) with 95% CIs for BMD changes at the lumbar spine (LS) and femoral neck (FN). Results We identified three eligible trials with a total of 62 participants. In summary, the GC + EX intervention indicated statistically significantly higher SMDs for LS-BMD [SMD 1.50 (95% CI 0.23, 2.77)] but not for FN-BMD [0.64 (95% CI -0.89, 2.17)] compared with GC treatment alone. We observed substantial heterogeneity (LS-BMD I-2 = 71%, FN-BMD I-2 = 78%) between the study results. Conclusion Although more well-designed exercise studies are needed to address the issue of exercise effects on GC-induced osteoporosis (GIOP) in more detail, upcoming guidelines should pay more attention to the aspect of exercise for bone strengthening in GIOP. Registration number PROSPERO: CRD42022308155
CRIS-Team WoS Importer:2023-03-17

Exercise Effects on the Reduction of Low-Traumatic and Major Osteoporotic Fractures in Adults. Systematic Review and Meta-Analysis - Shojaa, Mahdieh; Hoffmann, Isabelle; Kohl, Matthias; von Stengel, Simon; Becker, Clemens; Gosch, Markus; Jakob, Franz; Kerschan-Schindl, Katharina; Kladny, Bernd; Lange, Uwe; Peters, Stefan; Schöne, Daniel; et al. (Osteologie, 2023)
The aim of the present systematic review and meta-analysis was to determine the effects of exercise on low-trauma overall and major osteoporotic fractures in adults. Our systematic search of six literature databases according to the PRISMA guideline was conducted up to May 22, 2021, and included controlled clinical exercise trials with (a) individuals >= 45 years, (b) cohorts without therapies/diseases related to bone metabolism or falls, (c) an intervention of >= 3 months, and (d) the number of low-traumatic fractures listed separately for the exercise (EG) and control (CG) groups. The study was registered in PROSPERO (ID: CRD42021250467). We applied a mixed-effects conditional Poisson regression model for the analysis. A total of 20 intervention studies with 21 EGs and 20 CGs were included in the analysis. The studies comprising a pooled number of participant-years of n=11,836 in the EG and n=11,275 in the CG. The meta-analysis determined significant effects of exercise on low-trauma overall fracture incidence (rate) ratio (IR: 0.67, 95% confidence interval (95%-CI): 0.51-0.87) and major osteoporotic fractures IR (0.69, 95%-CI: 0.52-0.92). Heterogeneity between the trials was moderate for low-trauma overall (I (2) =40%), and negligible (I (2) <1%) for major osteoporotic fractures. Funnel plots suggest low to moderate evidence of publication/small-study bias in study outcomes for low-trauma overall fractures. Despite some biometric limitations the present study provides further evidence of the positive effect of exercise on low-trauma overall and major osteoporotic fractures in community dwelling middle aged to older adults. With respect to low-trauma overall and major osteoporotic fractures reduction, the study results are comparable to current pharmaceutical agents.
CRIS-Team WoS Importer:2023-06-02
Keywords: Exercise - low-trauma fracture - major osteoporotic fracture - osteoporosis - fall reduction

Exercise Reduces the Number of Overall and Major Osteoporotic Fractures in Adults. Does Supervision Make a Difference? Systematic Review and Meta-Analysis - Hoffmann, Isabelle; Shojaa, Mahdieh; Kohl, Matthias; von Stengel, Simon; Becker, Clemens; Gosch, Markus; Jakob, Franz; Kerschan-Schindl, Katharina; Kladny, Bernd; Clausen, Juergen; Lange, Uwe; Middeldorf, Stefan; et al. (Journal of Bone and Mineral Research, 2022)
The purpose of this systematic review and meta-analysis (PROSPERO ID: CRD42021250467) was to evaluate the effects of exercise on low-trauma overall and major osteoporotic fractures (hip, spine, forearm, or humerus fractures) and to determine the corresponding effect of supervision of the exercise program. Our systematic search of six literature databases according to the PRISMA guideline was conducted from January 1, 2013 (ie, date of our last search) to May 22, 2021, and included controlled clinical exercise trials with (i) individuals aged ≥45 years, (ii) cohorts without therapies/diseases related to fractures, (iii) observation periods of ≥3 months, and (iv) the number of low-trauma fractures listed separately for the exercise (EG) and control (CG) groups. We included 20 intervention studies with 21 EGs and 20 CGs comprising a pooled number of participant-years of n = 11.836 in the EG and n = 11.275 in the CG. The mixed-effects conditional Poisson regression revealed significant effects of exercise on low-trauma overall incidence (rate) ratio (IR 0.67, 95% confidence interval [95% CI] 0.51–0.87) and major osteoporotic fractures IR (0.69, 95% CI 0.52–0.92). Heterogeneity between the trials was moderate for low-trauma overall (I2 = 40%) and negligible (I2 < 1%) for major osteoporotic fractures. Supervision of the exercise program plays a significant role in the reductions of overall and major osteoporotic fractures with IR about twice as favorable in the predominately supervised (IR 0.44; 95% CI 0.27–0.73 and 0.38; 0.19–0.76) versus the predominately non-supervised exercise trials (IR 0.83; 95% CI 0.60–1.14 and 0.82; 0.64–1.05). In summary, the present study provides evidence for the positive effect of exercise on low-trauma overall and major osteoporotic fractures in middle aged to older adults. Supervision of the exercise program is a crucial aspect in exercise programs on fracture reduction. Thus, home-based exercise protocols should increasingly implement online classes to ensure widely consistent supervision and monitoring of the exercise program. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
CRIS-Team Scopus Importer:2022-09-23
Keywords: EXERCISE; LOW-TRAUMA FRACTURE; OSTEOPOROTIC FRACTURES; OVERALL FRACTURES

Exercise training and bone mineral density in postmenopausal women: an updated systematic review and meta-analysis of intervention studies with emphasis on potential moderators - Mohebbi, Ramin; Shojaa, Mahdieh; Kohl, Matthias; von Stengel, Simon; Jakob, Franz; Kerschan-Schindl, Katharina; Lange, Uwe; Peters, Stefan; Thomasius, Friederike; Uder, Michael; Kemmler, Wolfgang (Osteoporosis international, 2023)
The aim of this systematic review and meta-analysis was (1) to determine exercise effects on bone mineral density (BMD) in postmenopausal women and (2) to address the corresponding implication of bone and menopausal status or supervision in postmenopausal women. A comprehensive search of eight electronic databases according to the PRISMA statement up to August 9, 2022, included controlled exercise trials ≥ 6 months. BMD changes (standardized mean differences: SMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) were considered as outcomes. Study group comparisons were conducted for osteopenia/osteoporosis versus normal BMD, early versus late postmenopausal women, and predominantly supervised versus predominantly non-supervised study arms. We applied an inverse heterogeneity (IVhet) model. In summary, 80 studies involving 94 training and 80 control groups with a pooled number of 5581 participants were eligible. The IVhet model determined SMDs of 0.29 (95% CI: 0.16–0.42), 0.27 (95% CI: 0.16–0.39), and 0.41 (95% CI: 0.30–0.52) for LS, FN, and THBMD, respectively. Heterogeneity between the trial results varied from low (I2 = 20%, TH BMD) to substantial (I2 = 68%, LS-BMD). Evidence for publication bias/small study effects was negligibly low (FN-, TH-BMD) to high (LSBMD). We observed no significant differences (p >.09) for exercise effects on LS-, FN-, or TH-BMD-LS between studies/study arms with or without osteopenia/osteoporosis, early versus late postmenopausal women, or predominantly supervised versus non-supervised exercise programs. Using robust statistical methods, the present work provides further evidence for a positive effect of exercise on BMD in postmenopausal women. Differences in bone status (osteopenia/osteoporosis versus normal bone), menopausal status (early versus late postmenopausal), and supervision (yes versus no) did not significantly affect the exercise effects on BMD at LS or proximal femur.
CRIS-Team Scopus Importer:2023-02-17
Keywords: Bone strength; Exercise trials; Menopause; Older women; Osteoporosis; Supervision

Experiences in the treatment of patients with multiple head and neck paragangliomas - Künzel, Julian; De Tristan, Julie; Mantsopoulos, Konstantinos; Koch, Michael; Baussmerth, Marcela; Zenk, Johannes; Iro, Heinrich (American Journal of Otolaryngology, 2014)
To analyze treatment results in the multidisciplinary management of patients with multiple head and neck paragangliomas (HNPs).Retrospective analysis including all patients with multiple HNPs (VP, vagal paraganglioma; JTP, jugulotympanic paraganglioma; CBT, carotid body tumor) treated between 2000 and 2013 at a tertiary referral center.Ten patients (three men, seven women) had 25 HNPs (two VPs, eight JTPs, and 15 CBTs). The age range at diagnosis was 31-71 years (mean 40.9 years, median 37 years). Nine tumors (four CBTs, three JTPs, two VPs) were treated only with stereotactic radiotherapy (SRT; 50.4-56Gy, mean 55.3Gy) or in one case intensity-modulated radiotherapy (60 Gy). Nine tumors were treated with surgery alone (eight CBTs, one JTP) and three JTPs with subtotal surgery combined with adjuvant SRT. A "wait and scan" strategy was used in three cases (two CBTs, one JTP). The mean follow-up period was 4.3 years (range 0.1-13 years, median 4 years). The rate of tumor control with surgery and/or SRT was 100% (21/21). One patient with a wait-and-scan strategy for CBT had slow asymptomatic progression during a 13-year follow-up.The treatment results in this series of patients with multiple HNPs show that a very high rate of long-term tumor control with low morbidity can be achieved using tailored and individualized approaches. All of the different treatment strategies available should be discussed with the patient. In particular, the treatment should involve a multidisciplinary team of experts in the fields of nuclear medicine, genetics, pathology, radiology, radio-oncology, and surgery.
EVALuna2:18180

Experimental determination of pore shapes using phase retrieval from q-space NMR diffraction - Demberg, Kerstin; Bertleff, Marco; Bachert, Peter; Kuder, Tristan Anselm; Laun, Frederik Bernd (Physical Review E, 2018)
This paper presents an approach to solving the phase problem in nuclear magnetic resonance (NMR) diffusion pore imaging, a method that allows imaging the shape of arbitrary closed pores filled with an NMR-detectable medium for investigation of the microstructure of biological tissue and porous materials. Classical q-space imaging composed of two short diffusion-encoding gradient pulses yields, analogously to diffraction experiments, the modulus squared of the Fourier transform of the pore image which entails an inversion problem: An unambiguous reconstruction of the pore image requires both magnitude and phase. Here the phase information is recovered from the Fourier modulus by applying a phase retrieval algorithm. This allows omitting experimentally challenging phase measurements using specialized temporal gradient profiles. A combination of the hybrid input-output algorithm and the error reduction algorithm was used with dynamically adapting support (shrinkwrap extension). No a priori knowledge on the pore shape was fed to the algorithm except for a finite pore extent. The phase retrieval approach proved successful for simulated data with and without noise and was validated in phantom experiments with well-defined pores using hyperpolarized xenon gas.
EVALuna2:36251

Exploration of new contrasts, targets, and MR imaging and spectroscopy techniques for neuromuscular disease-A workshop report of working group 3 of the biomedicine and molecular biosciences COST action BM1304 MYO-MRI - Strijkers, Gustav J.; Araujo, Ericky C.A.; Azzabou, Noura; Bendahan, David; Blamire, Andrew; Burakiewicz, Jedrek; Carlier, Pierre G.; Damon, Bruce; Deligianni, Xeni; Froeling, Martijn; Heerschap, Arend; Hollingsworth, Kieren G.; et al. (Journal of Neuromuscular Diseases, 2019)
Neuromuscular diseases are characterized by progressive muscle degeneration and muscle weakness resulting in functional disabilities. While each of these diseases is individually rare, they are common as a group, and a large majority lacks effective treatment with fully market approved drugs. Magnetic resonance imaging and spectroscopy techniques (MRI and MRS) are showing increasing promise as an outcome measure in clinical trials for these diseases. In 2013, the European Union funded the COST (co-operation in science and technology) action BM1304 called MYO-MRI (www.myo-mri.eu), with the overall aim to advance novel MRI and MRS techniques for both diagnosis and quantitative monitoring of neuromuscular diseases through sharing of expertise and data, joint development of protocols, opportunities for young researchers and creation of an online atlas of muscle MRI and MRS. In this report, the topics that were discussed in the framework of working group 3, which had the objective to: Explore new contrasts, new targets and new imaging techniques for NMD are described. The report is written by the scientists who attended the meetings and presented their data. An overview is given on the different contrasts that MRI can generate and their application, clinical needs and desired readouts, and emerging methods.
CRIS-Team Scopus Importer:2019-07-09
Keywords: biomarker; MRI; MRS; muscle; myo-mri; Neuromuscular disease; outcome measure

Exploring the differences between radiographic joint space width and MRI cartilage thickness changes using data from the IMI-APPROACH cohort - Jansen, Mylène P.; Roemer, Frank; Marijnissen, Anne Karien C.A.; Kloppenburg, Margreet; Blanco, Francisco J.; Haugen, Ida K.; Berenbaum, Francis; Lafeber, Floris P.J.G.; Welsing, Paco M.J.; Mastbergen, Simon C.; Wirth, Wolfgang (Skeletal Radiology, 2023)
Objective: Longitudinal weight-bearing radiographic joint space width (JSW) and non-weight-bearing MRI-based cartilage thickness changes often show weak correlations. The current objective was to investigate these correlations, and to explore the influence of different factors that could contribute to longitudinal differences between the two methods. Methods: The current study included 178 participants with medial osteoarthritis (OA) out of the 297 knee OA participants enrolled in the IMI-APPROACH cohort. Changes over 2 years in medial JSW (ΔJSWmed), minimum JSW (ΔJSWmin), and medial femorotibial cartilage thickness (ΔMFTC) were assessed using linear regression, using measurements from radiographs and MRI acquired at baseline, 6 months, and 1 and 2 years. Pearson R correlations were calculated. The influence of cartilage quality (T2 mapping), meniscal extrusion (MOAKS scoring), potential pain-induced unloading (difference in knee-specific pain scores), and increased loading (BMI) on the correlations was analyzed by dividing participants in groups based on each factor separately, and comparing correlations (slope and strength) between groups using linear regression models. Result: Correlations between ΔMFTC and ΔJSWmed and ΔJSWmin were statistically significant (p < 0.004) but weak (R < 0.35). Correlations were significantly different between groups based on cartilage quality and on meniscal extrusion: only patients with the lowest T2 values and with meniscal extrusion showed significant moderate correlations. Pain-induced unloading or BMI-induced loading did not influence correlations. Conclusions: While the amount of loading does not seem to make a difference, weight-bearing radiographic JSW changes are a better reflection of non-weight-bearing MRI cartilage thickness changes in knees with higher quality cartilage and with meniscal extrusion.
CRIS-Team Scopus Importer:2023-01-13
Keywords: Cartilage thickness; JSW; Meniscus; MRI; T2 mapping; Weight-bearing

Exposition of the operator's eye lens and efficacy of radiation shielding in fluoroscopically guided interventions Exposition der Augenlinse des Untersuchers und Effizienz der Strahlenschutzmittel bei fluoroskopischen Interventionen - Galster, M.; Guhl, C.; Uder, Michael; Adamus, R. (Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2013)
Purpose: Efficacy of radiation protection tools for the eye lens dose of the radiologist in fluoroscopic interventions. Materials and Methods: A patient phantom was exposed using a fluoroscopic system. Dose measurements were made at the eye location of the radiologist using an ionization chamber. The setting followed typical fluoroscopic interventions. The reduction of scattered radiation by the equipment-mounted shielding (undercouch drapes and overcouch top) was evaluated. The ceiling-suspended lead acrylic glass screen was tested in scattered radiation generated by a slab phantom. The protective properties of different lead glass goggles and lead acrylic visors were evaluated by thermoluminescence measurements on a head phantom in the primary beam. Results: The exposition of the lens of about 110 to 550 μSv during radiologic interventions is only slightly reduced by the undercouch drapes. Applying the top in addition to the drapes reduces the lens dose by a factor of 2 for PA projections. In 25°LAO the dose is reduced by a factor between 1.2 and 5. The highest doses were measured for AP angulations furthermore the efficacy of the equipment-mounted shielding is minimal. The ceiling-suspended lead screen reduced scatter by a factor of about 30. The lead glass goggles and visors reduced the lens dose up to a factor of 8 to 10. Depending on the specific design, the tested models are less effective especially for radiation from lateral with cranial angulation of the beam. Occasionally the visors even caused an increase of dose. Conclusion: The exposition of the eye lens can be kept below the new occupational limit recommended by the ICRP if the radiation shielding equipment is used consistently. © Georg Thieme Verlag KG Stuttgart · New York.
CRIS-Team Scopus Importer:2023-03-08
Keywords: eye lens dose; interventional radiology; lead glass goggles; radiation shielding

Extended Multimodal Flat Detector CT Imaging in Acute Ischemic Stroke: A Pilot Study - Hölter, Philip; Lang, Stefan; Beuscher, Vanessa; Kallmünzer, Bernd; Manhart, Michael; Schwab, Stefan; Dörfler, Arnd (Journal of Digital Imaging, 2023)
By using Flat detector computed tomography (FD-CT), a one-stop-shop approach in the diagnostic workup of acute ischemic stroke (AIS) might be achieved. Although information on upstream vessels is warranted, dedicated FD-CT protocols which include the imaging of the cervical vasculature are still lacking. We aimed to prospectively evaluate the implementation of a new multimodal FD-CT protocol including cervical vessel imaging in AIS patients. In total, 16 patients were included in this study. Eight patients with AIS due to large vessel occlusion (LVO) prospectively received a fully multimodal FD-CT imaging, including non-enhanced flat detector computed tomography (NE-FDCT), dynamic perfusion flat detector computed tomography (FD-CTP) and flat detector computed tomography angiography (FD-CTA) including cervical imaging. For comparison of time metrics and image quality, eight AIS patients, which received multimodal CT imaging, were included retrospectively. Although image quality of NE-FDCT and FD-CTA was rated slightly lower than NE-CT and CTA, all FD-CT datasets were of diagnostic quality. Intracerebral hemorrhage exclusion and LVO detection was reliably possible. Median door-to-image time was comparable for the FD-CT group and the control group (CT:30 min, IQR27-58; FD-CT:44.5 min, IQR31-55, p = 0.491). Door-to-groin-puncture time (CT:79.5 min, IQR65-90; FD-CT:59.5 min, IQR51-67; p = 0.016) and image-to-groin-puncture time (CT:44 min, IQR30-50; FD-CT:14 min, IQR12-18; p < 0.001) were significantly shorter, when patients were directly transferred to the angiosuite, where FD-CT took place. Our study indicates that using a new fully multimodal FD-CT approach including imaging of cervical vessels for first-line imaging in AIS patients is feasible and comparable to multimodal CT imaging with substantial potential to streamline the stroke workflow.
CRIS-Team Scopus Importer:2023-02-03
Keywords: Flat Detector Computed Tomography; Interventional; Stroke; Workflow

Extent of simultaneous radiation dose and iodine reduction at stable image quality in computed tomography of the chest: A systematic approach using automated tube voltage adaption and iterative reconstructions - Eller, Achim; Wüst, Wolfgang; Saake, Marc; Ellmann, Stephan; Kämmerer, Nadine; Hammon, Matthias; Janka, Rolf Matthias; Uder, Michael; May, Matthias (Medicine, 2018)
BACKGROUND: Aim of this study was to systematically combine tube voltage adaptation and iterative reconstructions for reduction of iodine and radiation dose. METHODS: Settings for the study protocol were evaluated in ex-ante trials to provide image quality that is comparable to a reference protocol at 120 kV with tube current modulation. Consecutive patients were randomized to undergo computed tomography (CT) of the chest using the study protocol (n = 62) or reference protocol (n = 50). Objective and subjective image quality was assessed and compared. RESULTS: Tube voltage was decreased to 100 kV in 47 patients and to 80 kV in 15 patients in the study group. The iodine dosage (16.1 vs 10.5 g) and the effective radiation dose (3.6 vs 2.5 mSv) were significantly decreased in the study group (both P < .001). Contrast-to-noise ratio was comparable in the pulmonary trunk and increased in the aorta (P < .01). Subjective image quality was comparable without statistically significance. CONCLUSIONS: Simultaneous reductions in iodine dosage and radiation dose by one-third are feasible for CT of the chest.
EVALuna2:34701

External Beam Accelerated Partial Breast Irradiation in Early Breast Cancer and the Risk for Radiogenic Pneumonitis - Ott, Oliver; Stillkrieg, Wilhelm; Lambrecht, Ulrike; Sauer, Tim-Oliver; Schweizer, Claudia; Lamrani, Allison; Strnad, Vratislav; Hack, Caroline; Beckmann, Matthias; Uder, Michael; Fietkau, Rainer; Distel, Luitpold (Cancers, 2022)
Simple Summary Accelerated partial breast irradiation represents a well-established and safe treatment alternative for selected patients with early stage breast cancer after breast-conserving surgery. In a prospective trial on external beam partial breast irradiation, the risk for radiogenic pneumonitis is analyzed. After a median follow-up of 56 (1-129) months, radiogenic pneumonitis grade 2 appeared in only 1/170 (0.6%) patients. Compared to standard whole breast irradiation, the radiation doses applied to the lungs were very low. The patient with the radiogenic pneumonitis was found to have a generally increased radiation susceptibility. Using accelerated partial breast irradiation, the risk of radiogenic pneumonitis appeared quite low and may be limited to very exceptional cases associated with innate risk factors with an increased radiation susceptibility. In order to evaluate the risk for radiation-associated symptomatic pneumonitis in a prospective external beam accelerated partial breast irradiation (APBI) trial, between 2011 and 2021, 170 patients with early stage breast cancer were enclosed in the trial. Patients were eligible for study participation if they had a histologically confirmed breast cancer or an exclusive ductal carcinoma in situ (DCIS), a tumor size <= 3 cm, free safety margins >= 2 mm, no involved axillary lymph nodes, tumor bed clips, and were >= 50 years old. Patients received APBI with 38 Gy with 10 fractions in 10 consecutive working days. The trial was registered at the German Clinical Trials Registry, DRKS-ID: DRKS00004417. Median follow-up was 56 (1-129) months. Ipsilateral lung MLD, V20, and V30 were 4.3 +/- 1.4 Gy, 3.0 +/- 2.0%, and 1.0 +/- 1.0%, respectively. Radiogenic pneumonitis grade 2 appeared in 1/170 (0.6%) patients two months after radiotherapy. Ipsilateral MLD, V20, and V30 were 6.1 Gy, 7, and 3% in this patient. Additionally, individual radiosensitivity was increased in this specific patient. Compared to WBI, APBI leads to lower lung doses. Using APBI, the risk of symptomatic radiogenic pneumonitis is very low and may be limited, with an ipsilateral V20 < 3% to very exceptional cases associated with innate risk factors with an increased radiation susceptibility.
CRIS-Team WoS Importer:2022-08-12

Extracranial temporal bone paragangliomas: Re-defining the role of otologic surgery within the scope of function-preserving multimodal concepts - Mantsopoulos, Konstantinos; Thimsen, Vivian; Eisenhut, Felix; Weissmann, Thomas; Putz, Florian; Fietkau, Rainer; Iro, Heinrich; Hornung, Joachim; Taha, Lava (American Journal of Otolaryngology, 2022)
Introduction: The aim of this study was to present our concept in the management of extracranial temporal bone paragangliomas and demonstrate the outcome after primary surgical management of the middle ear component, with an individualized indication for adjuvant radiotherapy. Materials and methods: The records of all patients treated for extracranial jugulotympanic paragangliomas by means of primary surgical management between 2010 and 2021 were studied retrospectively. Results: Twenty-nine patients made up our study sample (mean age 58.8 years). 15 cases were managed solely by means of surgery. Out of the remaining 14 cases with reduction of the middle ear component, adjuvant irradiation was performed in 11 cases, whereas a wait-and-scan strategy was adopted at the patient's request in three cases. No further growth was detected in our study cases. Conclusion: Our protocol seems to be associated with an acceptable quality of life and a satisfactory oncologic outcome.
CRIS-Team WoS Importer:2021-10-15

Fan-to-Parallel Beam Conversion: Deriving Neural Network Architectures Using Precision Learning - Syben-Leisner, Christopher; Stimpel, Bernhard; Lommen, Jonathan; Würfl, Tobias; Dörfler, Arnd; Maier, Andreas (Informatik aktuell, 2019)
CRIS-Team Scopus Importer:2019-05-14

Fast Adaptive Regularization for Perfusion Parameter Computation - Manhart, Michael; Maier, Andreas; Hornegger, Joachim; Dörfler, Arnd (Bildverarbeitung für die Medizin, 2015)
UnivIS-Import:2015-04-17:Pub.2015.tech.IMMD.IMMD5.fastad_9

Fast adaptive regularization for perfusion parameter computation: Tuning the Tikhonov regularization parameter to the SNR by regression - Manhart, Michael; Maier, Andreas; Hornegger, Joachim; Dörfler, Arnd (Informatik aktuell, 2015)
Computation of perfusion parameters by deconvolution from contrast-enhanced time-resolved CT or MR perfusion data sets is an illconditioned problem. Thus, adequate regularization and determination of corresponding regularization parameters is required. We present a novel method for Tikhonov regularization for perfusion imaging to locally adapt parameters to the SNR level by using a regression function. In an numerical evaluation our simple approach provided similar or even superior results compared to methods applying computationally more demanding L-curve analysis.
CRIS-Team Scopus Importer:2022-08-05

Fast Automatic Segmentation of the Esophagus from 3D CT data using a Probabilistic Model - Feulner, Johannes; Zhou, S. Kevin; Seifert, Sascha; Hornegger, Joachim; Comaniciu, Dorin; Cavallaro, Alexander Josef (Springer-verlag, 2009)
Automated segmentation of the esophagus in CT images is of high value to radiologists for oncological examinations of the mediastinum. It can serve as a guideline and prevent confusion with pathological tissue. However, segmentation is a challenging problem due to low contrast and versatile appearance of the esophagus. In this paper, a two step method is proposed which first finds the approximate shape using a "detect and connect" approach. A classifier is trained to find short segments of the esophagus which are approximated by an elliptical model. Recently developed techniques in discriminative learning and pruning of the search space enable a rapid detection of possible esophagus segments. Prior shape knowledge of the complete esophagus is modeled using a Markov chain framework, which allows efficient inferrence of the approximate shape from the detected candidate segments. In a refinement step, the surface of the detected shape is non-rigidly deformed to better fit the organ boundaries. In contrast to previously proposed methods, no user interaction is required. It was evaluated on 117 datasets and achieves a mean segmentation error of 2.28mm with less than 9s computation time. © 2009 Springer-Verlag.
UnivIS-Import:2015-04-16:Pub.2009.tech.IMMD.IMMD5.fastau

Fast in vivo Na-23 imaging and T-2* mapping using accelerated 2D-FID UTE magnetic resonance spectroscopic imaging at 3 T: Proof of concept and reliability study - Alhulail, Ahmad A.; Xia, Pingyu; Shen, Xin; Nichols, Miranda; Volety, Srijyotsna; Farley, Nicholas; Thomas, Micheal Albert; Nagel, Armin Michael; Dydak, Ulrike; Emir, Uzay E. (Magnetic Resonance in Medicine, 2020)
Purpose: To implement an accelerated MR-acquisition method allowing to map T-2* relaxation and absolute concentration of sodium within skeletal muscles at 3T.
CRIS-Team WoS Importer:2020-11-27

Fast online-customized (FOCUS) parallel transmission pulses: A combination of universal pulses and individual optimization - Herrler, Jürgen; Liebig, Patrick; Gumbrecht, Rene; Ritter, Dieter; Schmitter, Sebastian; Maier, Andreas; Schmidt, Manuel; Uder, Michael; Dörfler, Arnd; Nagel, Armin Michael (Magnetic Resonance in Medicine, 2021)
Purpose: To mitigate spatial flip angle (FA) variations under strict specific absorption rate (SAR) constraints for ultra-high field MRI using a combination of universal parallel transmit (pTx) pulses and fast subject-specific optimization. Methods: Data sets consisting of B0, (Formula presented.) maps, and virtual observation point (VOP) data were acquired from 72 subjects (study groups of 48/12 healthy Europeans/Asians and 12 Europeans with pathological or incidental findings) using an 8Tx/32Rx head coil on a 7T whole-body MR system. Combined optimization values (COV) were defined as combination of spiral-nonselective (SPINS) trajectory parameters and an energy regularization weight. A set of COV was optimized universally by simulating the individual RF pulse optimizations of 12 training data sets (healthy Europeans). Subsequently, corresponding universal pulses (UPs) were calculated. Using COV and UPs, individually optimized pulses (IOPs) were calculated during the sequence preparation phase (maximum 15 s). Two different UPs and IOPs were evaluated by calculating their normalized root-mean-square error (NRMSE) of the FA and SAR in simulations of all data sets. Seven additional subjects were examined using an MPRAGE sequence that uses the designed pTx excitation pulses and a conventional adiabatic inversion. Results: All pTx pulses resulted in decreased mean NRMSE compared to a circularly polarized (CP) pulse (CP = 28%, UPs = 17%, and IOPs = 12%). UPs and IOPs improved homogeneity for all subjects. Differences in NRMSE between study groups were much lower than differences between different pulse types. Conclusion: UPs can be used to generate fast online-customized (FOCUS) pulses gaining lower NRMSE and/or lower SAR values.
CRIS-Team Scopus Importer:2021-01-15
Keywords: 7 T; k; parallel transmission (pTx); SPINS; ultra-high-field MRI; universal pulses

Fast WASABI post-processing: Access to rapid B0 and B1 correction in clinical routine for CEST MRI - Papageorgakis, Christos; Firippi, Eleni; Gy, Benoit; Boutelier, Timothé; Khormi, Ibrahim; Al-iedani, Oun; Lechner-Scott, Jeannette; Ramadan, Saadallah; Liebig, Patrick; Schuenke, Patrick; Zaiß, Moritz; Casagranda, Stefano (Magnetic Resonance Imaging, 2023)
CEST MRI methods, such as APT and NOE imaging reveal biomarkers with significant diagnostic potential due to their ability to access molecular tissue information. Regardless of the technique used, CEST MRI data are affected by static magnetic B0 and radiofrequency B1 field inhomogeneities that degrade their contrast. For this reason, the correction of B0 field-induced artefacts is essential, whereas accounting for B1 field inhomogeneities have shown significant improvements in image readability. In a previous work, an MRI protocol called WASABI was presented, which can map simultaneously B0 and B1 field inhomogeneities, while maintaining the same sequence and readout types as used for CEST MRI. Despite the highly satisfactory quality of B0 and B1 maps computed from the WASABI data, the post-processing method is based on an exhaustive search of a four-parameter space and an additional four-parameter non-linear model fitting step. This leads to long post-processing times that are prohibitive in clinical practice. This work provides a new method for fast post-processing of WASABI data with outstanding acceleration of the parameter estimation procedure and without compromising its stability. The resulting computational acceleration makes the WASABI technique suitable for clinical use. The stability of the method is demonstrated on phantom data and clinical 3 Tesla in vivo data.
CRIS-Team Scopus Importer:2023-08-11
Keywords: APT; B0-correction; B1-correction; CEST; Field mapping; Noe; Post-processing; WASABI

Fatal Encephalitis Associated with Borna Disease Virus 1 - Korn, Klaus; Coras, Roland; Bobinger, Tobias; Herzog, Sibylle M.; Lücking, Hannes; Stoehr, Roland; Huttner, Hagen; Hartmann, Arndt; Enßer, Armin (New England Journal of Medicine, 2018)
EVALuna2:34851

Fatal lymphomatoid granulomatosis with primary CNS-involvement in an immunocompetent 80-year-old woman - Olmes, David G.; Agaimy, Abbas; Kloska, Stephan; Linker, Ralf (BMJ Case Reports, 2014)
An 80-year-old woman presented with weight loss, fatigue, dizziness and a brain stem lesion. Extensive work-up revealed lymphomatoid granulomatosis (LYG) with primary clinical manifestation in the central nervous system (CNS), a rare Epstein-Barr virus-driven multisystem lymphoproliferative disorder, to be causative for the symptoms. Immunochemotherapy consisting of rituximab and temozolomide was started, but the disease progressed and the patient subsequently died. Histology, diagnostic criteria, differential diagnosis and treatment options for LYG with CNS involvement are discussed. This case demonstrates that LYG with CNS involvement may necessitate more aggressive treatment approaches than combination therapy with rituximab and temozolomide.
EVALuna2:6736

Feasibility of cerebral blood volume mapping by flat panel detector CT in the angiography suite: First experience in patients with acute middle cerebral artery occlusions - Struffert, Tobias; Deuerling-Zheng, Y.; Engelhorn, Tobias; Kloska, Stephan; Gölitz, Philipp; Koehrmann, M.; Schwab, S.; Strother, C. M.; Dörfler, Arnd (American Journal of Neuroradiology, 2012)
BACKGROUND AND PURPOSE: A new FPCT application offers the possibility of perfusion (FPCT CBV) and parenchymal (FPCT) imaging within the angiography suite. We tested the hypothesis that findings in FPCT CBV and FPCT would correlate with those obtained using MSCT and PCT. MATERIALS AND METHODS: In 16 patients with acute MCA occlusion, FPCT CBV was performed immediately posttreatment. The volume of tissue having abnormal CBV values was determined by FPCT CBV and PCT images. Stroke volume on follow-up MSCT was determined, CBV values in the effected parenchyma were measured, and FPCT images were reviewed. RESULTS: In 6 cases, we found a FPCT CBV value identical or higher (hyperemia) in comparison with the contralateral side. In 10 cases, we found CBV lesions with values lower (oligemia) than the contralateral brain tissue. We found a high correlation of CBV lesion volume on FPCT CBV images to stroke volume on follow-up MSCT (r = 0.9, P < .05) in the oligemia group. Absolute FPCT CBV and PCT CBV values were comparable and showed good correlation (r = 0.9, P < .05). In 8 patients, contrast medium extravasation was visible. CONCLUSIONS: The new FPCT application allows assessment of CBV in acute stroke patients. Our initial results indicate that these measurements may predict final infarct volume. The ability to assess this key parameter of cerebral perfusion within the angiographic suite may improve the management of these patients.
CRIS-Team Scopus Importer:2022-08-05

Feasibility of deuterium magnetic resonance spectroscopy of 3-O-Methylglucose at 7 Tesla - Hartmann, Benedikt; Müller, Max; Seyler, Lisa; Bäuerle, Tobias; Wilferth, Tobias; Avdievitch, Nikolai; Ruhm, Loreen; Henning, Anke; Lesiv, Alexei; Ivashkin, Pavel; Uder, Michael; Nagel, Armin Michael (PLoS ONE, 2021)
Deuterium Magnetic Resonance Spectroscopy (DMRS) is a non-invasive technique that allows the detection of deuterated compounds in vivo. DMRS has a large potential to analyze uptake, perfusion, washout or metabolism, since deuterium is a stable isotope and therefore does not decay during biologic processing of a deuterium labelled substance. Moreover, DMRS allows the distinction between different deuterated substances. In this work, we performed DMRS of deuterated 3-O-Methylglucose (OMG). OMG is a non-metabolizable glucose analog which is transported similar to D-glucose. DMRS of OMG was performed in phantom and in vivo measurements using a preclinical 7 Tesla MRI system. The chemical shift (3.51 ± 0.1 ppm) and relaxation times were determined. OMG was injected intravenously and spectra were acquired over a period of one hour to monitor the time evolution of the deuterium signal in tumor-bearing rats. The increase and washout of OMG could be observed. Three different exponential functions were compared in terms of how well they describe the OMG washout. A mono-exponential model with offset seems to describe the observed time course best with a time constant of 1910 ± 770 s and an offset of 2.5 ± 1.2 mmol/l (mean ± std, N = 3). Chemical shift imaging could be performed with a voxel size of 7.1 mm × 7.1 mm × 7.9 mm. The feasibility of DMRS with deuterium labelled OMG could be demonstrated. These data might serve as basis for future studies that aim to characterize glucose transport using DMRS.
CRIS-Team Scopus Importer:2021-06-18

Feasibility of Dixon magnetic resonance imaging to quantify effects of physical training on muscle composition-A pilot study in young and healthy men - Grimm, Alexandra; Nickel, Marcel D.; Chaudry, Oliver; Uder, Michael; Jakob, Franz; Kemmler, Wolfgang; Quick, Harald H.; Engelke, Klaus (European Journal of Radiology, 2019)
Changes in muscle-fat-composition affect physical performance and muscular function, like strength and power. The purpose of the present study was to investigate whether changes in soft tissue composition of the thigh and changes in muscle size and composition resulting from physical training were detectable with Dixon magnetic resonance imaging (MRI).
CRIS-Team WoS Importer:2019-05-03

Feasibility of In Vivo Metal Artifact Reduction in Contrast-Enhanced Dedicated Spiral Breast Computed Tomography - Wetzl, Matthias; Wenkel, Evelyn; Steiding, Chrisitan; Ruth, Veikko; Emons, Julius; Wasser, Martin N.; Uder, Michael; Ohlmeyer, Sabine (Diagnostics, 2023)
Background: Radiopaque breast markers cause artifacts in dedicated spiral breast-computed tomography (SBCT). This study investigates the extent of artifacts in different marker types and the feasibility of reducing artifacts through a metal artifact reduction (MAR) algorithm. Methods: The pilot study included 18 women who underwent contrast-enhanced SBCT. In total, 20 markers of 4 different types were analyzed for artifacts. The extent of artifacts with and without MAR was measured via the consensus of two readers. Image noise was quantitatively evaluated, and the effect of MAR on the detectability of breast lesions was evaluated on a 3-point Likert scale. Results: Breast markers caused significant artifacts that impaired image quality and the detectability of lesions. MAR decreased artifact size in all analyzed cases, even in cases with multiple markers in a single slice. The median length of in-plain artifacts significantly decreased from 31 mm (range 11–51 mm) in uncorrected to 2 mm (range 1–5 mm) in corrected images (p ≤ 0.05). Artifact size was dependent on marker size. Image noise in slices affected by artifacts was significantly lower in corrected (13.6 ± 2.2 HU) than in uncorrected images (19.2 ± 6.8 HU, p ≤ 0.05). MAR improved the detectability of lesions affected by artifacts in 5 out of 11 cases. Conclusion: MAR is feasible in SBCT and improves the image quality and detectability of lesions.
CRIS-Team Scopus Importer:2023-10-20
Keywords: breast CT; breast imaging; computed tomography; metal artifact reduction

Feasibility of Respiratory-gated High-pitch Spiral CT:: Free-breathing Inspiratory Image Quality - Lell, Michael; Scharf, Michael; Eller, Achim; Wüst, Wolfgang; Allmendinger, Thomas; Fuchs, Florian; Achenbach, Stephan; Uder, Michael; May, Matthias (Academic Radiology, 2016)
This study aimed to develop and implement a respiratory-gated setup for dual-source computed tomography (CT) at high pitch to examine patients in a reproducible inspiratory phase.Twenty-one patients underwent free-breathing respiratory-gated chest CT using a high-pitch scan mode no more than 6 months after inspiratory breath-held nongated CT, which serves as reference. Scan parameters were as follows: pitch = 3.4, 128 × 0.6 mm collimation, 0.28 s gantry rotation time, and 150 ref.mAs per tube at 120 kV. The examinations were triggered using the tidal wave provided by a respiratory-gating system as input signal. Image quality was assessed focusing on artifacts and delineation of the anatomical and pathological structures. Lung volumes were measured on both free-breathing and reference examinations.All examinations were performed without complications. Image quality was high with both protocols. Significantly less motion artifacts were recorded with the high-pitch mode compared to the reference (P = 0.02). Most of the artifacts were located in the peripheral parts of the lower lobes for the study group and in the central part of the left lower lobe for the reference. Average total lung volume was 4.5 ± 1.5 L in respiratory-gated examinations and 5.8 ± 0.9 L in examinations with breath-hold in inspiration.High-pitch chest CT scanning during free breathing minimizes motion artifacts, improving image quality in patients with limited breath-holding abilities. To assure scanning in an inspiratory phase, data acquisition should be triggered with a respiratory-gating system.
EVALuna2:12027

Feasibility Study: 2-D Self-Navigation using Compressed Sensing Reconstruction for Respiratory Gating in Free-breathing 3-D CINE Imaging - Prochaska, Ivo; Wetzl, Jens; Forman, Christoph; Nagel, Armin Michael; Maier, Andreas (Proceedings of the 25th Annual Meeting of the ISMRM, 2017)
UnivIS-Import:2017-07-10:Pub.2017.tech.IMMD.IMMD5.feasib

Feature Constrained Non-rigid Image Registration - Han, Jingfeng; Hornegger, Joachim; Kuwert, Torsten; Bautz, Werner; Römer, Wolfgang (Frontiers in Simulation, 2005)

Feature-guided deep learning reduces signal loss and increases lesion CNR in diffusion-weighted imaging of the liver - Führes, Tobit; Saake, Marc; Lorenz, Jennifer; Seuß, Hannes; Bickelhaupt, Sebastian; Uder, Michael; Laun, Frederik Bernd (Zeitschrift für Medizinische Physik, 2023)
Purpose: This research aims to develop a feature-guided deep learning approach and compare it with an optimized conventional post-processing algorithm in order to enhance the image quality of diffusion-weighted liver images and, in particular, to reduce the pulsation-induced signal loss occurring predominantly in the left liver lobe. Methods: Data from 40 patients with liver lesions were used. For the conventional approach, the best-suited out of five examined algorithms was chosen. For the deep learning approach, a U-Net was trained. Instead of learning “gold-standard” target images, the network was trained to optimize four image features (lesion CNR, vessel darkness, data consistency, and pulsation artifact reduction), which could be assessed quantitatively using manually drawn ROIs. A quality score was calculated from these four features. As an additional quality assessment, three radiologists rated different features of the resulting images. Results: The conventional approach could substantially increase the lesion CNR and reduce the pulsation-induced signal loss. However, the vessel darkness was reduced. The deep learning approach increased the lesion CNR and reduced the signal loss to a slightly lower extent, but it could additionally increase the vessel darkness. According to the image quality score, the quality of the deep-learning images was higher than that of the images obtained using the conventional approach. The radiologist ratings were mostly consistent with the quantitative scores, but the overall quality ratings differed among the readers. Conclusion: Unlike the conventional algorithm, the deep-learning algorithm increased the vessel darkness. Therefore, it may be a viable alternative to conventional algorithms.
CRIS-Team Scopus Importer:2023-08-25
Keywords: Cardiac motion artifact; Deep learning; Diffusion; Liver; Neural network; Oncology

Fibrinolysis Treatment for Cerebral Intraventricular Hemorrhage: A Temporal and Spatial Voxel-Based Analysis - Strinitz, Marc; Kuramatsu, Joji; Kaschka, Iris; Kloska, Stephan; Dörfler, Arnd; Schwab, Stefan; Huttner, Hagen; Seifert, Frank (Journal of Neuroimaging, 2016)
A voxel-based statistical approach on computer tomographic data in patients with intracerebral hemorrhage (ICH) and acute intraventricular hemorrhage (IVH) was used to evaluate spatial and temporal patterns of intraventricular blood in patients treated with intraventricular fibrinolysis (IVF) or without.IVH shapes were systematically assessed three dimensionally in patients with supratentorial ICH at three intervals of time (day of admission, day 4 ± 1, day 7+). The boundaries of the intraventricular blood clot were delineated on computed tomography (CT) scans using dedicated software. The CT scan and the IVH shape were transferred into stereotaxic space. In a second step, voxel-based statistics on group level were used to correlate the distribution of intraventricular blood with the interval and the treatment group.Altogether 45 patients, 29 with IVF therapy and 16 without, were eligible to be included into this study. We found significant (false discovery rate [FDR] correction, q < .05) reduction of the intraventricular blood between day of admission and day 7 + for the third and fourth ventricle and parts of both lateral ventricles. In addition, we were able to show a significant difference between the IVF therapy and the conventionally treated group at day 4 ± 1 for the third ventricle.The data indicate that voxel-based analysis on group level can be used to compare the time course and the distribution of intraventricular hemorrhage. This technique could be an interesting tool for future research on ICH with IVH.
EVALuna2:22457

Fibroblast Activation Protein (FAP) PET-CT for Depicting Inflammatory Joint Damage in Patients with Psoriatic Arthritis - Rauber, Simon; Mohammadian, Hashem; Schmidkonz, Christian; Atzinger, Armin; Raimondo, Maria Gabriella; Labinsky, Hannah; Treutlein, Christoph; Knitza, Johannes; Maschauer, Simone; Roemer, Frank; Prante, Olaf; Kuwert, Torsten; et al. (ARTHRITIS & RHEUMATOLOGY, 2022)
CRIS-Team WoS Importer:2023-01-13

FIBROBLAST ACTIVATION PROTEIN (FAP) PET-CT IMAGING ALLOWS TO DEPICT INFLAMMATORY JOINT REMODELING IN PATIENTS WITH PSORIATIC ARTHRITIS - Schmidkonz, Christian; Rauber, Simon; Raimondo, Maria Gabriella; Labinsky, Hannah; Atzinger, Armin; Treutlein, Christoph; Knitza, Johannes; Maschauer, Simone; Roemer, Frank; Prante, Olaf; Kuwert, Torsten; Canete, J. D. D.; et al. (ANNALS OF THE RHEUMATIC DISEASES, 2022)
CRIS-Team WoS Importer:2022-11-04

Fine needle aspiration cytology of lymph nodes in breast cancer follow-up is a feasible alternative to watchful waiting and to histology - Hammon, Matthias; Dankerl, Peter; Janka, Rolf Matthias; Wachter, David; Hartmann, Arndt; Schulz-Wendtland, Rüdiger; Uder, Michael; Wenkel, Evelyn (BMC Women's Health, 2015)
Early detection of loco-regional breast cancer recurrence improves patients' overall survival, as treatment can be initiated or active treatment can be changed. If a suspicious lymph node is diagnosed during a follow-up exam, surgical excision is often performed. The aim of this study was to evaluate the diagnostic performance of the minor invasive ultrasound-guided fine-needle aspiration cytology (FNAC) in sonomorphologically suspicious lymph nodes in breast cancer follow-up.Between April 2010 and November 2012, we performed ultrasound-guided FNAC in 38 sonographically suspicious lymph nodes of 37 breast cancer follow-up patients. Cytological specimens were evaluated if the sample material was sufficient for diagnosis and if they contained cancer cells. Patients with negative cytology were followed up clinically and sonographically. To evaluate the diagnostic performance we calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for physical examination, the different sonomorphological malignancy criteria and FNAC.In 36/38 (94.7 %) lymph nodes, the pathologist had enough material to establish a final diagnosis; in 2/38 (5.3 %) lymph nodes, the probe material was non-evaluable during cytology, these 2 were excluded from further statistical evaluation. Cytology revealed malignancy in 21 lymph nodes and showed no evidence for malignancy in 15 lymph nodes. There was no evidence for malignant disease in follow-up exams in the 15 cytologically benign lymph nodes with an average follow-up time of 3 years. The diagnostic performances of physical examination and FNAC were: Sensitivity 52/100 %, specificity 88/100 %, PPV 85/100 %, NPV 60/100 %, respectively.Our preliminary results show that FNAC is a safe and fast diagnostic approach for the evaluation of suspicious lymph nodes in the follow-up of patients with breast cancer and, thus, together with follow-up represents a feasible alternative to surgery.
EVALuna2:6744

First Experience With SPECT/CT Using a 99mTc-Labeled Inhibitor for Prostate-Specific Membrane Antigen in Patients With Biochemical Recurrence of Prostate Cancer - Reinfelder, Julia; Kuwert, Torsten; Beck, Michael; Sanders, James C.; Ritt, Philipp; Schmidkonz, Christian; Hennig, Peter; Prante, Olaf; Uder, Michael; Wullich, Bernd; Goebell, Peter (Clinical Nuclear Medicine, 2017)
Prostate-specific membrane antigen (PSMA) is overexpressed in most prostate cancers (PCs). Here, we report our first experience using the Tc-labeled PSMA inhibitor MIP-1404 (Progenics Pharmaceuticals, Inc, Tarrytown, NY) in 60 patients with biochemically recurrent PC.Whole-body planar scintigraphy and SPECT/CT of the lower abdominal pelvic region of 60 patients with biochemical relapse of PC were analyzed retrospectively. In these subjects, an average dose of 733.1 ± 49.5 MBq (19.8 ± 1.3 mCi) Tc-labeled MIP-1404 was injected 4 to 5 hours prior to imaging. In addition to visual evaluation, SUVmax were determined in the tumor lesions using a previously developed protocol for quantitative SPECT/CT.In 42 of 60 patients, Tc-MIP-1404-positive lesions could be detected (70%; 95% confidence interval [CI], 0.58-0.82). Twenty patients had Tc-MIP-1404-positive lymph nodes suggestive of metastasis, 14 patients had pathological uptake in the prostate region indicative of local recurrence, and for another 19 patients, there was tracer accumulation in the skeleton (n = 18) or lungs (n = 1). Detection rate was 91.4% (95% CI, 0.82-1) at prostate-specific antigen levels greater than 2 ng/mL and 40.0% (95% CI, 0.21-0.59) at lower prostate-specific antigen values (P < 0.01). Of the 60 patients, in total, 82 positive lesions were analyzed quantitatively. Average SUVmax of the lesions was 16.3 ± 21.6 with a range of 1.7 to 142.9.Tc-labeled PSMA inhibitor MIP-1404 is a promising SPECT tracer for detection of locally recurrent or metastatic prostate cancer.
EVALuna2:13859

First German Guideline on Diagnostics and Therapy of Clinically Non-Functioning Pituitary Tumors - Deutschbein, Timo; Jaursch-Hancke, Cornelia; Knappe, Ulrich J.; Saeger, Wolfgang; Flitsch, Joerg; Bojunga, Joerg; Buchfelder, Michael; Ditzen, Beate; Gerlach, Ruediger; Gertzen, Elfriede; Honegger, Juergen; Horstmann, Gerhard A.; et al. (Experimental and Clinical Endocrinology and Diabetes, 2021)
Although non-functioning pituitary tumors are frequent, diagnostic and therapeutic concepts are not well standardized. We here present the first German multidisciplinary guideline on this topic. The single most important message is to manage the patients by a multidisciplinary team (consisting at least of an endocrinologist, a neurosurgeon, and a (neuro-) radiologist). The initial diagnostic work-up comprises a detailed characterization of both biochemical (focusing on hormonal excess or deficiency states) and morphological aspects (with magnetic resonance imaging of the sellar region). An ophthalmological examination is only needed in presence of symptoms or large tumors affecting the visual system. Asymptomatic, hormonally inactive tumors allow for a 'wait and scan' strategy. In contrast, surgical treatment by an experienced pituitary surgeon is standard of care in case of (impending) visual impairment. Therapeutic options for incompletely resected or recurrent tumors include re-operation, radiotherapy, and observation; the individual treatment plan should be developed multidisciplinary. Irrespective of the therapeutic approach applied, patients require long-term follow-up. Patient with larger pituitary tumors or former surgery/radiotherapy should be regularly counseled regarding potential symptoms of hormonal deficiency states.
CRIS-Team WoS Importer:2021-04-02

FLAIRfusion Processing with Contrast Inversion : Improving Detection and Reading Time of New Cerebral MS Lesions - Schmidt, Manuel; Linker, Ralf; Lang, S.; Lücking, Hannes; Engelhorn, Tobias; Kloska, Stephan; Uder, Michael; Dörfler, Arnd; Dankerl, Peter; Cavallaro, Alexander Josef (Clinical Neuroradiology, 2017)
To evaluate the performance of an innovative image processing approach for detection of T2-weighted hyperintense multiple sclerosis (MS) lesions.In this study 20 consecutive patients with inflammatory demyelinating lesions were retrospectively evaluated of whom 10 patients featured progressive disease and 10 a stable lesion load. 3 mm transversal FLAIRfusion imaging was processed and archived. Image processing was performed through landmark-based 3D co-registration of the previous and current isotropic FLAIR examination followed by inversion of image contrast. Thereby, the hyperintense signals of the unchanged MS plaques extinguish each other, while newly developed lesions appear bright on FLAIRfusion. Diagnostic performance was evaluated by 4 experienced readers. Consensus reading supplied the reference standard. Sensitivity, specificity, NPV (negative predictive value), PPV (positive predictive value), interreader agreement and reading time were the outcome measures analyzed.Combined sensitivity was 100% at a specificity of 88.2%, with PPV ranging from 83.3% to 90.1% and NPV at 100%. Reading time was nearly 5-fold faster than conventional side by side comparison (35.6 s vs. 163.7 s, p < 0.001). Cohen's kappa was excellent (>0.75; p < 0.001) and Cronbach's alpha was 0.994.FLAIRfusion provides reliable detection of newly developed MS lesions along with strong interreader agreement across all levels of expertise in 35 s of reading time.
EVALuna2:14615

Flat detector computed tomography angiography with intravenous contrast application: Feasibility for visualization of cerebral arterial vasculature - Saake, Marc; Breuer, Lorenz; Gölitz, Philipp; Ott, Sabine; Struffert, Tobias; Dörfler, Arnd (Journal of Neuroimaging, 2013)
BACKGROUND AND PURPOSE: The aim of our study was to evaluate flat detector computed tomography angiography with peripheral intravenous contrast material application (FD-CTA) for visualization of cerebral arteries in comparison with intravenous multidetector computed tomography angiography (CTA) and intraarterial digital subtraction angiography (DSA). METHODS: The study was approved by the local institutional review board and informed consent was obtained by all participants. Ten patients underwent FD-CTA, CTA, and DSA of the cerebral arterial vasculature for suspected cerebrovascular disease. The image data were evaluated by two readers in consensus for the visualization of cerebral arterial segments on a 5-point scale (0 = vessel cannot be distinguished; 4 = excellent image quality). The Wilcoxon signed-rank test was used for statistical analysis. Note that P < .05 was considered to indicate a significant difference. RESULTS: The depiction of cerebral arterial segments with FD-CTA was significantly superior compared to CTA in most vessel segments (P < .05 in 20 of 23 anatomic regions) and was without significant difference compared with DSA in large and medium intracranial vessels. CONCLUSIONS: The results suggest that the cerebral arteries can be visualized by FD-CTA in high resolution, in many vessel segments comparable to DSA. © 2012 by the American Society of Neuroimaging.
CRIS-Team Scopus Importer:2022-08-05
Keywords: Angiography; Cerebral; Computed tomography; Flat detector; Intravenous

Flat-detector computed tomography evaluation in an experimental animal aneurysm model after endovascular treatment: A pilot study - Ott, Sabine; Gölitz, Philipp; Adamek, Edyta; Royalty, Kevin; Dörfler, Arnd; Struffert, Tobias (Interventional Neuroradiology, 2015)
We compared flat-detector computed tomography angiography (FD-CTA) to multislice computed tomography (MS-CTA) and digital subtracted angiography (DSA) for the visualization of experimental aneurysms treated with stents, coils or a combination of both.In 20 rabbits, aneurysms were created using the rabbit elastase aneurysm model. Seven aneurysms were treated with coils, seven with coils and stents, and six with self-expandable stents alone. Imaging was performed by DSA, MS-CTA and FD-CTA immediately after treatment. Multiplanar reconstruction (MPR) was performed and two experienced reviewers compared aneurysm/coil package size, aneurysm occlusion, stent diameters and artifacts for each modality.In aneurysms treated with stents alone, the visualization of the aneurysms was identical in all three imaging modalities. Residual aneurysm perfusion was present in two cases and visible in DSA and FD-CTA but not in MS-CTA. The diameter of coil-packages was overestimated in MS-CT by 56% and only by 16% in FD-CTA compared to DSA (p < 0.05). The diameter of stents was identical for DSA and FD-CTA and was significantly overestimated in MS-CTA (p < 0.05). Beam/metal hardening artifacts impaired image quality more severely in MS-CTA compared to FD-CTA.MS-CTA is impaired by blooming and beam/metal hardening artifacts in the visualization of implanted devices. There was no significant difference between measurements made with noninvasive FD-CTA compared to gold standard of DSA after stenting and after coiling/stent-assisted coiling of aneurysms. FD-CTA may be considered as a non-invasive alternative to the gold standard 2D DSA in selected patients that require follow up imaging after stenting.
EVALuna2:14478

Flat-Panel Computed Tomography (DYNA-CT) in Neuroradiology. From High-Resolution Imaging of Implants to One-Stop-Shopping for Acute Stroke - Dörfler, Arnd; Gölitz, Philipp; Engelhorn, Tobias; Kloska, Stephan; Struffert, Tobias (Clinical Neuroradiology, 2015)
Originally aimed at improving standard radiography by providing higher absorption efficiency and a wider dynamic range, flat-panel detector technology has meanwhile got widely accepted in the neuroradiological community. Especially flat-panel detector computed tomography (FD-CT) using rotational C-arm mounted flat-panel detector technology is capable of volumetric imaging with a high spatial resolution. By providing CT-like images of the brain within the angio suite, FD-CT is able to rapidly visualize hemorrhage and may thus improve complication management without the need of patient transfer. As "Angiographic CT" FD-CT may be helpful during many diagnostic and neurointerventional procedures and for noninvasive monitoring and follow-up. In addition, spinal interventions and high-resolution imaging of the temporal bone might also benefit from FD-CT. Finally, using novel dynamic perfusion and angiographic protocols, FD-CT may provide functional information on brain perfusion and vasculature with the potential to replace standard imaging in selected acute stroke patients.
EVALuna2:22997

Flat panel detector angiographic CT for stent-assisted coil embolization of broad-based cerebral aneurysms - Richter, Gregor; Engelhorn, Tobias; Struffert, Tobias; Dölken, Marc; Ganslandt, Oliver; Hornegger, Joachim; Kalender, Willi Alfred; Dörfler, Arnd (American Journal of Neuroradiology, 2007)
BACKGROUND AND PURPOSE: The purpose of this work was to evaluate angiographic CT (ACT) in the combined application of a self-expanding neurovascular stent and detachable platinum coils in the management of broad-based and fusiform intracranial aneurysms. MATERIALS AND METHODS: Eleven patients harboring wide-necked intracranial aneurysms were treated with a flexible self-expanding neurovascular stent and subsequent aneurysm embolization with platinum microcoils. ACT was performed after the interventional procedure to analyze stent position and the relationship of coils to the stent. Postprocessing included multiplanar reconstructions (MPRs) and maximum intensity projections (MIPs). ACT volume datasets were postprocessed for soft tissue visualization. RESULTS: Accurate stent placement with subsequent coil occlusion of the aneurysms was feasible in all of the patients. Similar to nonsubtracted digital subtraction angiography (DSA) images, radiopaque platinum stent markers showed excellent visibility in ACT as well. The stent struts themselves, hardly visible in nonsubtracted DSA, were visible in MPRs and MIPs of ACT in all of the patients. In aneurysms larger than 10 mm in diameter, accurate stent assessment at the level of the coils was limited due to beam hardening artifacts. Postprocedural ACT in all of the patients did not reveal any evidence of procedure-related intracranial hemorrhage. CONCLUSION: ACT provides cross-sectional, 3D visualization of endovascular stents otherwise hardly visible with plain fluoroscopy. ACT enables us to accurately determine stent position, which may be helpful in complex stent-assisted aneurysm coiling procedures. However, in aneurysms larger than 10 mm in diameter, beam hardening artifacts caused by the endoaneurysmal coil package impair visibility of the stent. Further data are necessary to evaluate the usefulness of ACT in stent-assisted aneurysm coiling.

Flat Panel Detector Computed Tomography-Guided Placement of External Ventricular Drains Using the BrainLAB Headband and Precalibrated Disposable Stylet Instrument: A Cadaveric Feasibility Study - Feulner, Julian; Lang, Stefan; Buder, Thomas; Struffert, Tobias; Buchfelder, Michael; Brandner, Sebastian (World Neurosurgery, 2018)
BACKGROUND: The standard freehand method for the insertion of external ventricular drains (EVDs) is associated with high rates of incorrect placement. Use of neuronavigation has been shown to reduce the rates of inaccurately positioned EVDs. We present a novel neuronavigation-based approach for EVD placement using flat panel detector computed tomography (FDCT) imaging. METHODS: Four cadaveric heads were used for neuronavigated placement of EVDs using the BrainLAB reference headband in combination with laser surface registration and the precalibrated disposable stylet. In 2 cases, conventional multislice CT imaging was performed to reference neuronavigation. In the other 2 cases, preprocedural imaging was performed with FDCT. After inserting the EVDs, all heads were examined again with the identical imaging method as used before the procedure, followed by evaluation of catheter position. RESULTS: Our data demonstrate that FDCT imaging provides adequate image quality for referencing neuronavigation and performing navigated neurosurgery. All EVDs showed an optimal position in the ipsilateral frontal horn. Use of a BrainLAB reference headband combined with laser surface registration and the precalibrated disposable stylet affords the advantage of not requiring rigid fixation in a clamp. CONCLUSIONS: Our presented method is fast, accurate, and easy to use. Furthermore, this study is the first to demonstrate that navigated neurosurgery can be performed on the basis of FDCT imaging.
EVALuna2:212791

Flow-compensated diffusion encoding in MRI for improved liver metastasis detection - Laun, Frederik Bernd; Führes, Tobit; Seuß, Hannes; Müller, Astrid; Bickelhaupt, Sebastian; Stemmer, Alto; Benkert, Thomas; Uder, Michael; Saake, Marc (PLoS ONE, 2022)
Magnetic resonance (MR) diffusion-weighted imaging (DWI) is often used to detect focal liver lesions (FLLs), though DWI image quality can be limited in the left liver lobe owing to the pulsatile motion of the nearby heart. Flow-compensated (FloCo) diffusion encoding has been shown to reduce this pulsation artifact. The purpose of this prospective study was to intra-individually compare DWI of the liver acquired with conventional monopolar and FloCo diffusion encoding for assessing metastatic FLLs in non-cirrhotic patients. Forty patients with known or suspected multiple metastatic FLLs were included and measured at 1.5 T field strength with a conventional (monopolar) and a FloCo diffusion encoding EPI sequence (single refocused; b-values, 50 and 800 s/mm2). Two board-certified radiologists analyzed the DWI images independently. They issued Likert-scale ratings (1 = worst, 5 = best) for pulsation artifact severity and counted the difference of lesions visible at b = 800 s/mm2 separately for small and large FLLs (i.e., < 1 cm or > 1 cm) and separately for left and right liver lobe. Differences between the two diffusion encodings were assessed with the Wilcoxon signed-rank test. Both readers found a reduction in pulsation artifact in the liver with FloCo encoding (p < 0.001 for both liver lobes). More small lesions were detected with FloCo diffusion encoding in both liver lobes (left lobe: six and seven additional lesions by readers 1 and 2, respectively; right lobe: five and seven additional lesions for readers 1 and 2, respectively). Both readers found one additional large lesion in the left liver lobe. Thus, flow-compensated diffusion encoding appears more effective than monopolar diffusion encoding for the detection of liver metastases.
CRIS-Team Scopus Importer:2022-08-05

Flow-diverting stents allow efficient treatment of unruptured, intradural dissecting aneurysms of the vertebral artery: An explanatory approach using in vivo flow analysis - Gölitz, Philipp; Struffert, Tobias; Eyüpoglu, Ilker Yasin; Knossalla, Frauke; Dörfler, Arnd; Hölter, Philip (Interventional Neuroradiology, 2016)
Our study aimed to evaluate the efficiency of flow-diverting stents (FDS) in treating unruptured, intradural dissecting aneurysms of the vertebral artery (VADAs). Additionally, the effect of FDS on the aneurysmal flow pattern was investigated by performing in vivo flow analysis using parametric color coding (PCC).We evaluated 11 patients with unruptured, intradural VADAs, treated with FDS. Pre- and postinterventional DSA-series were postprocessed by PCC, and time-density curves were calculated. The parameters aneurysmal inflow-velocity, outflow-velocity and relative time-to-peak (rTTP) were calculated. Pre- and postinterventional values were compared and correlated with the occlusion rate after six months.Follow-up DSA detected 10 aneurysms occluded, meaning an occlusion rate of 91%. No procedure-related morbidity and mortality was found. Flow analyses revealed a significant reduction of aneurysmal inflow- velocity and prolongation of rTTP after FDS deployment. Concerning aneurysm occlusion, the postinterventional outflow-velocity turned out to be a marginally statistically significant predictor. A definite threshold value (-0.7 density change/s) could be determined for the outflow-velocity that allows prediction of complete aneurysm occlusion with high sensitivity and specificity (100%).Using FDS can be considered an efficient and safe therapy option in treating unruptured, intradural VADA. From in vivo flow analyses the postinterventional aneurysmal outflow-velocity turned out to be a potential predictor for later complete aneurysm occlusion. Here, it might be possible to determine a threshold value that allows prediction of aneurysm occlusion with high specificity and sensitivity. As fast, applicable and easy-to-handle tool, PCC could be used for procedural monitoring and might contribute to further treatment optimization.
EVALuna2:22441

Fluid flow simulation on the Cell Broadband Engine using the lattice Boltzmann method - Stürmer, Markus; Götz, Jan; Richter, G.; Dörfler, Arnd; Rüde, Ulrich (Computers & Mathematics with Applications, 2009)
In this paper we present a fast lattice Boltzmann fluid solver that has been performance optimized and tailored for the Cell Broadband Engine Architecture. Many design decisions were motivated by the long range objective to simulate blood flow in human blood vessels, especially in aneurysms, but have proven to be much more generally applicable. After explaining implementation details and how they were influenced by the target platform, the performance and memory requirements of this prototype solver are evaluated. © 2009 Elsevier Ltd. All rights reserved.
UnivIS-Import:2015-03-09:Pub.2009.tech.IMMD.lsinfs.fluidf
Keywords: Aneurysm; Blood flow; CBEA; Cell processor; Hemodynamics; High performance computing; Lattice Boltzmann

Fluid suppression in amide proton transfer-weighted (APTw) CEST imaging: New theoretical insights and clinical benefits - Schüre, Jan-Rüdiger; Casagranda, Stefano; Sedykh, Maria; Liebig, Patrick; Papageorgakis, Christos; Mancini, Laura; Bisdas, Sotirios; Nichelli, Lucia; Pinter, Nandor; Mechtler, Laszlo; Jafari, Ramin; Boddaert, Nathalie; et al. (Magnetic Resonance in Medicine, 2023)
Purpose: Amide proton transfer-weighted (APTw) MRI at 3T provides a unique contrast for brain tumor imaging. However, APTw imaging suffers from hyperintensities in liquid compartments such as cystic or necrotic structures and provides a distorted APTw signal intensity. Recently, it has been shown that heuristically motivated fluid suppression can remove such artifacts and significantly improve the readability of APTw imaging. Theory and Methods: In this work, we show that the fluid suppression can actually be understood by the known concept of spillover dilution, which itself can be derived from the Bloch-McConnell equations in comparison to the heuristic approach. Therefore, we derive a novel post-processing formula that efficiently removes fluid artifact, and explains previous approaches. We demonstrate the utility of this APTw assessment in silico, in vitro, and in vivo in brain tumor patients acquired at MR scanners from different vendors. Results: Our results show a reduction of the CEST signals from fluid environments while keeping the APTw-CEST signal intensity almost unchanged for semi-solid tissue structures such as the contralateral normal appearing white matter. This further allows us to use the same color bar settings as for conventional APTw imaging. Conclusion: Fluid suppression has considerable value in improving the readability of APTw maps in the neuro-oncological field. In this work, we derive a novel post-processing formula from the underlying Bloch-McConnell equations that efficiently removes fluid artifact, and explains previous approaches which justify the derivation of this metric from a theoretical point of view, to reassure the scientific and medical field about its use.
CRIS-Team Scopus Importer:2023-12-22
Keywords: APTw CEST imaging; fluid suppression; MTRasym; post-processing

FRA-1 TRANSCRIPTION FACTOR EXPRESSION IN MACROPHAGES FOSTER INFLAMMATION DURING RHEUMATOID ARTHRITIS DEVELOPMENT - Hannemann, Nicole; Schnelzer, Anne; Jordan, Jutta; Eberhardt, Martin; Schleicher, Ulrike; Hueber, Axel; Reid, Stephen; Sonnewald, Sophia; Bäuerle, Tobias; Vera, Julio; Bogdan, Christian; Schett, Georg; et al. (2017)
EVALuna2:13497

Fractures associated with ACL injury need to be taken seriously - Guermazi, Ali; Roemer, Frank; Crossley, Kay M.; Crema, Michel D. (British Journal of Sports Medicine, 2018)
EVALuna2:34713

FRED Flow Diverter: A Study on Safety and Efficacy in a Consecutive Group of 50 Patients - Lücking, Hannes; Engelhorn, Tobias; Lang, Stefan; Gölitz, Philipp; Kloska, Stephan; Roessler, Karl; Dörfler, Arnd (American Journal of Neuroradiology, 2017)
BACKGROUND AND PURPOSE: Endovascular flow diverters are increasingly used for the treatment of cerebral aneurysms. We assessed the safety and efficacy of the Flow-Redirection Endoluminal Device (FRED) in a consecutive series of 50 patients. MATERIALS AND METHODS: Inclusion criteria were wide-neck, blister-like, or fusiform/dissecting aneurysms independent of size, treated with the FRED between February 2014 and May 2015. Assessment criteria were aneurysm occlusion, manifest ischemic stroke, bleeding, or death. The occlusion rate was assessed at 3 months with flat panel CT and at 6 months with DSA by using the Raymond classification and the O'Kelly-Marotta grading scale. RESULTS: Fifty patients with 52 aneurysms were treated with 54 FREDs; 20 patients were treated with the FRED and coils. Aneurysm size ranged from 2.0 to 18.5 mm. Deployment of the FRED was successful in all cases. There were no device-associated complications. One patient developed mild stroke symptoms that fully receded within days. There have been no late-term complications so far and no treatment-related mortality. Initial follow-up at 3 months showed complete occlusion in 72.3% of the overall study group, Six-month follow-up showed total and remnant-neck occlusion in 87.2% of patients, distributed over 81.5% of the FRED-only cases and 95.0% of the cases with combined treatment. CONCLUSIONS: The FRED flow diverter is a safe device for the treatment of cerebral aneurysms of various types. Our data reveal high occlusion rates at 3 and 6 months, comparable with those in other flow diverters. Long-term occlusion rates are expected.
EVALuna2:33142

Free-Breathing and Single-Breath Hold Compressed Sensing Real-Time MRI of Right Ventricular Function in Children with Congenital Heart Disease. - Treutlein, Christoph; Zeilinger, Martin; Dittrich, Sven; Roth, Jessica; Wetzl, Matthias; Heiß, Rafael; Wuest, Wolfgang; May, Matthias; Uder, Michael; Rompel, Oliver (Diagnostics, 2023)
(1) Purpose: to compare right ventricular (RV) functional parameters in children with surgically repaired congenital heart disease (CHD) using single/double breath hold (BH) and free-breathing (FB) real-time compressed sensing (CS) cine cardiac magnetic resonance (cMRI) with standard retrospective segmented multi breath hold (RMB) cine cMRI. (2) Methods: Twenty patients with CHD underwent BH and FB, as well as RMB cine cMRI, at 3T to obtain a stack of continuous axial images of the RV. Two radiologists independently performed qualitative analysis of the image quality (rated on a 5-point scale; 1 = non-diagnostic to 5 = excellent) and quantitative analysis of the RV volume measurements. (3) Results: The best image quality was provided by RMB (4.5; range 2-5) compared to BH (3.9; range 3-5; p = 0.04) and FB (3.6; range 3-5; p < 0.01). The RV functional parameters were comparable among BH, FB, and RMB with a difference of less than 5%. The scan times for BH (44 ± 38 s, p < 0.01) and FB (24 ± 7 s, p < 0.01) were significantly reduced compared to for RMB (261 ± 68 s). (4) Conclusions: CS-FB and CS-BH real-time cine cMRI in children with CHD provides diagnostic image quality with excellent accuracy for measuring RV function with a significantly reduced scan time compared to RMB.
EVALuna2:539552

Free-Breathing Low-Field MRI of the Lungs Detects Functional Alterations Associated With Persistent Symptoms After COVID-19 Infection. - Levy, Simon; Heiß, Rafael; Grimm, Robert; Grodzki, David; Hadler, Dominique; Voskrebenzev, Andreas; Vogel-Claussen, Jens; Fuchs, Florian; Strauss, Richard; Achenbach, Susanne; Hinsen, Maximilian; Klett, Daniel; et al. (Investigative Radiology, 2022)
OBJECTIVES: With the COVID-19 pandemic, repetitive lung examinations have become necessary to follow-up symptoms and associated alterations. Low-field MRI, benefiting from reduced susceptibility effects, is a promising alternative for lung imaging to limit radiations absorbed by patients during CT examinations, which also have limited capability to assess functional alterations. The aim of this investigative study was to explore the functional abnormalities that free-breathing 0.55 T MRI in combination with the phase-resolved functional lung (PREFUL) analysis could identify in patients with persistent symptoms after COVID-19 infection. MATERIALS AND METHODS: Seventy-four COVID-19 patients and 8 healthy volunteers were prospectively scanned in free-breathing with a balanced steady-state free-precession sequence optimized at 0.55 T, 5 months postinfection on average. Normalized perfusion (Q), fractional ventilation (FV), and flow-volume loop correlation (FVLc) maps were extracted with the PREFUL technique. Q, FV, and FVLc defects as well as defect overlaps between these metrics were quantified. Morphological turbo-spin-echo images were also acquired, and the extent of abnormalities was scored by a board-certified radiologist. To investigate the functional correlates of persistent symptoms, a recursive feature elimination algorithm was applied to find the most informative variables to detect the presence of persistent symptoms with a logistic regression model and a cross-validation strategy. All MRI metrics, sex, age, body mass index, and the presence of preexisting lung conditions were included. RESULTS: The most informative variables to detect persistent symptoms were the percentage of concurrent Q and FVLc defects and of areas free of those defects. A detection accuracy of 71.4% was obtained with these 2 variables when fitting the model on the entire dataset. Although none of the single variables differed between patients with and without persistent symptoms ( P > 0.05), the combined score of these 2 variables did ( P < 0.02). This score also showed a consistent increase from healthy volunteers (7.7) to patients without persistent symptoms (8.2) and with persistent symptoms (8.6). The morphological abnormality score showed poor correlation with the functional parameters. CONCLUSIONS: Functional pulmonary examinations using free-breathing 0.55 T MRI with PREFUL analysis revealed potential quantitative markers of impaired lung function in patients with persistent symptoms after COVID-19 infection, potentially complementing morphologic imaging. Future work is needed to explore the translational relevance and clinical implication of these findings.
EVALuna2:506323

Frequency and impact of enteric hyperoxaluria in pediatric short bowel syndrome: a retrospective single centre study - Schaefer, Jan Thomas; Schulz-Heise, Susanne; Rueckel, Aline; Rauh, Manfred; Jüngert, Jörg; Galiano, Matthias; Meier, Norbert; Wölfle, Joachim; Schiffer, Mario; Hörning, André (Frontiers in Pediatrics, 2023)
Objectives: The survival of pediatric patients with short bowel syndrome has improved in recent years. Enteric hyperoxaluria as a pathophysiological consequence has been hardly addressed so far. It can be associated with nephrolithiasis, nephrocalcinosis or even renal insufficiency. We assessed the prevalence of hyperoxaluria and its pathogenic consequences in a retrospective single centre study over the last 12 years. Methods: We conducted an internal database search for all pediatric patients suffering from short bowel syndrome treated from 2010 to 2022 in the department of pediatric gastroenterology as well as the pediatric nephrology and dialysis unit. Out of 56 patients identified, 26 patients were analysed for etiology of short bowel syndrome, renal excretion of oxalate (24/26), remaining short bowel and large intestinal length as well as further clinical parameters such as eGFR, nephrocalcinosis/urinary stone formation or stool frequency. Results: Hyperoxaluria was detected in 14/26 patients (54%). Nephrocalcinosis was present in four patients. Out of these four patients, hyperoxaluria could be proven (21% of all hyperoxaluric patients) in three cases, one hyperoxaluric patient had nephrolithiasis (7%). In one patient hyperoxaluria lead to end stage renal disease. We found that 80% of patients with volvulus developed enteric hyperoxaluria. None of the investigated factors had an effect on oxalate excretion. Conclusion: Enteric hyperoxaluria is a relevant pathophysiological finding in patients with short bowel syndrome occurring in about 50% of our cohort with multiple pathogenic complications. Regular screening for hyperoxaluria may be implemented in medical care for patients with short bowel syndrome. If necessary, prophylaxis, e.g., dietary advice or metaphylaxis should be initiated.
CRIS-Team Scopus Importer:2023-08-11
Keywords: enteric hyperoxaluria; hyperoxaluria; intestinal failure; kidney stone; nephrolithiasis; pediatric; short bowel syndrome

Frequency of MRI-detected peripheral osteoarthritis in athletes during the Summer Olympics in Rio 2016. - Merritt, Alexander; Roemer, Frank; Heiß, Rafael; Jarraya, Mohamed; Guermazi, Dorra; Hayashi, Daichi; Engebretsen, Lars; Crema, Michel D.; Guermazi, Ali (Osteoarthritis and Cartilage Open, 2021)
OBJECTIVE: To describe the frequency and severity of magnetic resonance imaging (MRI) based peripheral osteoarthritis (OA) in athletes during the Rio de Janeiro 2016 Olympic Games. METHODS: All MRIs of the peripheral joints in Olympic athletes, performed at the centralized imaging facility, either following acute trauma or for non-traumatic joint pain, were included. All MRIs were retrospectively reviewed for presence and severity of MRI-based OA using an adapted Outerbridge classification for cartilage and adapted classifications for other tissues. Scoring of MRI abnormalities was independently and retrospectively performed without reference to the on-site clinical reports. The frequencies of MRI-detected OA were tabulated and grouped into sports categories, athletes' age (<25; 25-29; and ≥30 years of age), and sex. RESULTS: 11,274 athletes participated in the Games. 320 athletes underwent MRI of the peripheral joints. One hundred sixty (50.0%) were female, 109 (34.1%) were <25 years, 132 (41.3%) between the ages of 25 and 29 years old, and 79 (24.7%) ≥30 years old. 53 (16.6%) had MRI-based OA, with slightly more than half having severe OA. In every age category, severe OA was the most frequent finding and there was a linear trend for increased likelihood of having OA with increasing age (Cochran-Armitage test, p ​= ​0.009). Frequencies of OA were similar in male and female athletes. The wrist (29.2%) and the knee (23.3%) were the most commonly affected joints. CONCLUSIONS: MRI-defined OA was not uncommon among elite athletes in this selected sample.
EVALuna2:523300

FREQUENCY OF OSTEOARTHRITIS IN ATHLETES PARTICIPATING IN SUMMER OLYMPICS IN RIO 2016 - Merritt, A.; Roemer, Frank; Heiß, Rafael; Jarraya, M.; Guermazi, D.; Engebretsen, L.; Crema, M. D.; Guermazi, A. (OSTEOARTHRITIS AND CARTILAGE, 2020)
CRIS-Team WoS Importer:2020-05-29

Frequency split metal artefact reduction in pelvic computed tomography - Lell, Michael; Meyer, Esther; Schmid, Matthias; Raupach, R.; May, Matthias; Uder, Michael; Kachelrieß, Marc (European Radiology, 2013)
Objectives: Artefacts from total hip replacement affect image quality and the visualisation of pelvic lesions on computed tomography (CT). We propose a frequency split (FS) approach in addition to the normalised metal artefact reduction (NMAR) algorithm that aims to suppress artefacts and improves image quality in patients with orthopaedic hardware. Methods: Data from ten consecutive patients with metal artefacts from uni- (n = 5) and bilateral (n = 4) total hip replacement or osteosynthesis (n = 1) were reconstructed with filtered back projection (FBP), linear interpolation MAR (LIMAR), NMAR, FSLIMAR and FSNMAR and analysed for image quality and severity of artefacts. Results: NMAR and FSNMAR significantly improved the assessment of the pelvic organs, lymph nodes and vessels compared with FBP, LIMAR or FSLIMAR (P < 0.05). Assessment of the metal hardware, joint and capsule was improved with the addition of FS (FSLIMAR, FSNMAR). No algorithm-related artefacts were detected in regions that did not contain metal. Conclusions: NMAR, FSLIMAR and FSNMAR have the potential to improve image quality in patients with artefacts from metal hardware and to improve the diagnostic accuracy of CT of the organs of the pelvis. Although introducing some algorithm-related artefacts, FSNMAR most accurately displayed adjacent bone and tissue next to metal implants. Key Points: • Orthopaedic metallic hardware often creates serious artefacts in computed tomography, hindering diagnosis. • The normalised metal artefact reduction (NMAR) algorithm was developed to suppress such artefacts. • NMAR improves CT assessment of pelvic organs in patients with orthopaedic hardware. • Addition of the frequency split technique (FSNMAR) helps assess tissue near metal hardware. • NMAR and FSNMAR are robust and computationally effective sinogram interpolation algorithms. © 2013 European Society of Radiology.
CRIS-Team Scopus Importer:2023-03-08
Keywords: Computed tomography; Frequency split; Metal artefact reduction; Sinogram interpolation; Total hip replacement

Frequent occurrence of therapeutically reversible CMV-associated encephalopathy during radiotherapy of the brain - Goerig, Nicole; Frey, Benjamin; Korn, Klaus; Fleckenstein, Bernhard; Überla, Klaus; Schmidt, Manuel; Dörfler, Arnd; Engelhorn, Tobias; Eyüpoglu, Ilker Yasin; Ruehle, Paul F.; Putz, Florian; Semrau, Sabine; et al. (Neuro-Oncology, 2016)
Neurological decline during radio(chemo)therapy of the brain is often attributed to disease progression or side effects of radiotherapy. Diagnosis of opportunistic neurotropic infections such as cytomegalovirus (CMV) infections is uncommon, even though high-grade gliomas and some brain metastases are known to contain CMV particles. We prospectively examined the frequency of CMV encephalopathy during radiotherapy of the brain.Fifty patients requiring whole-brain radiotherapy for brain metastases (n = 27) or local radio(chemo)therapy of the brain for high-grade gliomas (n = 23) were observed in the prospective observational GLIO-CMV-01 study. MRIs and blood samples were obtained before, halfway through, and at the end of radiotherapy. MRIs were screened for disease progression or increased intracranial pressure. Blood was tested for anti-CMV immunoglobulin (Ig)M, anti-CMV IgG, and CMV DNA.Thirty-two of 50 (64%) patients were positive for anti-CMV IgG before radio(chemo)therapy. Fifteen of those 32 (48%) developed viremia during or up to 28 days after treatment. Thirteen of those 15 (87%) required treatment for CMV-associated encephalopathy. MRIs were negative for disease progression, edema, or bleeding. None of the patients negative for anti-CMV IgG developed viremia, suggesting a reactivation rather than a primary infection.In the group at risk consisting of anti-CMV IgG+ patients, age >65 (P = .004) and the amount of dexamethasone taken during radio(chemo)therapy (P = .004) were associated with an increased risk for CMV-associated encephalopathy. One hundred and fifty days after the start of radio(chemo)therapy, survival was 74% (14/19) (no encephalopathy) versus 54% (7/13) (encephalopathy) (odds ratio, 0.42; 95% CI, 0.03-1.86; P = .25).CMV reactivation frequently causes encephalopathy during radio(chemo)therapy of the brain. The unexpected high incidence of this infection makes it highly clinically relevant for every treating physician.
EVALuna2:8306

From Early Radiographic Knee Osteoarthritis to Joint Arthroplasty: Determinants of Structural Progression and Symptoms - Roemer, Frank; Kwoh, C. Kent; Fujii, Tomoko; Hannon, Michael J.; Boudreau, Robert M.; Hunter, David J.; Eckstein, Felix; John, Markus R.; Guermazi, Ali (Arthritis & Rheumatism-Arthritis Care & Research, 2018)
OBJECTIVE: To assess structural progression in knees with no/mild radiographic osteoarthritis (OA) (i.e., Kellgren/Lawrence [K/L] grades 0-2) that will undergo knee replacement during a 5-year period; to assess differences in structural damage on magnetic resonance imaging (MRI) in knees with no/mild radiographic OA versus those with severe radiographic OA (i.e., K/L grades 3 and 4) at baseline; and to assess differences in pain levels between those groups. METHODS: All participants who underwent knee replacement from baseline to 60 months were drawn from the Osteoarthritis Initiative. MRIs were assessed for bone marrow lesions (BMLs), Hoffa synovitis, and effusion synovitis (i.e., hyperintensity signal changes in the fat pad and abnormal amount of capsular distension due to intraarticular joint fluid and/or synovial thickening) at baseline and at the time point before knee replacement (T0). The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) pain were used for pain characterization. WOMAC activities of daily living and KOOS quality of life were applied to characterize functional status of the included participants. Logistic regression was used to assess the association of no/mild radiographic OA with these MRI features and pain. RESULTS: Based on inclusion criteria, 181 knees were selected. Participants were predominantly female (57.8%) with a mean age of 64.4 years. A total of 51 knees (28.2%) had no/mild radiographic OA at baseline. Of these, 51.0% progressed to severe radiographic OA. No/mild radiographic OA knees showed higher odds of BMLs in the patellofemoral joint at baseline (odds ratio [OR] 7.92 [95% confidence interval (95% CI) 3.45-18.16]) and T0 (OR 9.44 [95% CI 4.00-22.28]) compared to severe radiographic OA knees. In addition, no/mild radiographic OA knees were associated with change from no pain to pain from baseline to T0 (adjusted OR 5.48 [95% CI 1.25-24.00]). CONCLUSION: More than half of the knees with no/mild radiographic OA before knee replacement progressed to severe radiographic OA during 4 years of follow-up. BMLs in the patellofemoral joint were more often seen among knees that had no/mild radiographic OA. Worsening pain status may contribute to knee replacement in knees with no/mild radiographic OA.
EVALuna2:35363

FSRT vs. SRS in Brain Metastases—Differences in Local Control and Radiation Necrosis—A Volumetric Study - Putz, Florian; Weissmann, Thomas; Oft, Dominik; Schmidt, Manuel; Roesch, Johannes; Siavooshhaghighi, Hadi; Filimonova, Irina; Schmitter, Charlotte; Mengling, Veit; Bert, Christoph; Frey, Benjamin; Lettmaier, Sebastian; et al. (Frontiers in Oncology, 2020)
Background: While the role of stereotactic radiotherapy for brain metastases is increasing, evidence on the comparative efficacy and safety of fractionated stereotactic radiotherapy (FSRT) and single-session radiosurgery (SRS) is scarce. Methods: Longitudinal volumetric analysis was performed in a consecutive cohort of 120 patients and 190 brain metastases (>0.065 cm3 in volume / > 5 mm in diameter) treated exclusively with FSRT (n = 98) and SRS (n = 92), respectively. A total of 972 tumor segmentations was used, averaging 5.1 time points per metastasis. Progression was defined using a volumetric extension of the RANO-BM criteria. Local control and radionecrosis were compared for lesions treated with FSRT and SRS, respectively. Results: Metastases treated with FSRT were significantly larger at baseline (mean, 4.66 vs. 0.40 cm3, p < 0.001). Biologically effective dose (BED) for metastases (α/β = 12, linear-quadratic-cubic model) was significantly associated with local control, whereas BED for normal brain (α/β = 2, linear-quadratic model) was significantly associated with radionecrosis. Median time to local progression was 22.9 months in the FSRT group compared to 14.5 months in the SRS group (p = 0.022). Overall radionecrosis rate at 12 months was 3.4% for FSRT and 14.8% for SRS (p = 0.010). Radionecrosis °IV requiring resection with histologic proof of radiation necrosis also was significantly reduced in the FSRT group (FSRT 0.0% vs. SRS 3.9%, p = 0.041). In multivariate analysis, FSRT was associated with reduced risk of progression (HR 0.47, p = 0.015) and reduced risk of radionecrosis (HR 0.18, p = 0.045). Conclusions: This volumetric study provides initial evidence that the improvements in therapeutic ratio expected for FSRT in larger brain metastases, might equally extend into the domain of smaller metastases, traditionally less considered for fractionated treatment. FSRT might constitute an important tool to further increase local control and reduce radionecrosis risk in stereotactic radiotherapy for brain metastases, that should be assessed in randomized intervention trials.
CRIS-Team Scopus Importer:2020-10-30
Keywords: brain metastases; fractionated stereotactic radiotherapy; radiobiological aspects; segmentation; stereotactic radiosurgery (SRS); stereotactic radiotherapy (SRT); volumetric analysis

Full field digital mammography (FFDM) versus cmos technology, specimen radiography system (SRS) and tomosynthesis (DBT) - Which system can optimise surgical therapy? - Schulz-Wendtland, Rüdiger; Dilbat, G.; Bani, Mayada; Fasching, Peter; Heusinger, K.; Lux, Michael P.; Löhberg, Christian; Brehm, Barbara; Hammon, Matthias; Saake, Marc; Dankerl, Peter; Jud, Sebastian; et al. (Geburtshilfe und Frauenheilkunde, 2013)
Aim: This prospective clinical study aimed to evaluate whether it would be possible to reduce the rate of re-excisions using CMOS technology, a specimen radiography system (SRS) or digital breast tomosynthesis (DBT) compared to a conventional full field digital mammography (FFDM) system. Material and Method: Between 12/2012 and 2/2013 50 patients were diagnosed with invasive breast cancer (BI-RADS™ 5). After histological verification, all patients underwent breast-conserving therapy with intraoperative imaging using 4 different systems and differing magnifications: 1. Inspiration™ (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 m pixel pitch, 8 lp/mm; 2. BioVision™ (Bioptics, Tucson, AZ, USA), CMOS technology, photodiode array, flat panel, tungsten source, focus 0.05, resolution 50 m pixel pitch, 12 lp/mm; 3. the Trident™ specimen radiography system (SRS) (Hologic, Bedford, MA, USA), amorphous selenium, tungsten source, focus 0.05, resolution 70 m pixel pitch, 7.1 lp/mm; 4. tomosynthesis (Siemens, Erlangen, Germany), amorphous selenium, tungsten source, focus 0.1 mm, resolution 85 m pixel pitch, 8 lp/mm, angular range 50 degrees, 25 projections, scan time > 20 s, geometry: uniform scanning, reconstruction: filtered back projection. The 600 radiographs were prospectively shown to 3 radiologists. Results: Of the 50 patients with histologically proven breast cancer (BI-RADS™ 6), 39 patients required no further surgical therapy (re-excision) after breast-conserving surgery. A retrospective analysis (n = 11) showed a significant (p < 0.05) increase of sensitivity with the BioVision™, the Trident™ and tomosynthesis compared to the Inspiration™ at a magnification of 1.0: 2.0 or 1.0: 1.0 (tomosynthesis) (2.6, 3.3 or 3.6 %), i.e. re-excision would not have been necessary in 2, 3 or 4 patients, respectively, compared to findings obtained with a standard magnification of 1.0: 1.0. Conclusion: The sensitivity of the BioVision™, the Trident™ and tomosynthesis was significantly (p < 0.05) higher and the rate of re-excisions was reduced compared to FFDM using a conventional detector at a magnification of 2.0 but without zooming. © Georg Thieme Verlag KG Stuttgart New York.
CRIS-Team Scopus Importer:2023-03-08
Keywords: Breast; breast cancer; breast malignancy; mammography

Fully automated nipple detection in 3D breast ultrasound images - Wang, Lei; Böhler, Tobias; Zöhrer, Fabian; Georgii, Joachim; Rauh, Claudia; Fasching, Peter; Brehm, Barbara; Schulz-Wendtland, Rüdiger; Beckmann, Matthias; Uder, Michael; Hahn, Horst K. (Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), 2014)
Nipple position provides useful diagnostic informations in reading automated 3D breast ultrasound (ABUS) images. The identification of nipples is required to localize and determine the quadrants of breast lesions. Additionally, the nipple position serves as an effective landmark to register an ABUS image to other imaging modalities, such as digital mammography, breast magnet resonance imaging (MRI), or tomosynthesis. Nevertheless, the presence of speckle noise induced by interference waves and variant imaging directions in ultrasonography poses challenges to the task. In this work, we propose a fast and automated algorithm to detect nipples in 3D breast ultrasound images. The method fully takes advantages of the consistent characteristics of ultrasonographic signals observed at nipples and employs a multi-scale Laplacian-based blob detector to eventually identify nipple positions. The accuracy of the proposed method was tested on 113 ABUS images, resulting in a distance error of 6.6±8.9 mm (mean ±std). © 2014 Springer International Publishing.
CRIS-Team Scopus Importer:2023-03-08

Functional ankle instability as a risk factor for osteoarthritis: Using T2-mapping to analyze early cartilage degeneration in the ankle joint of young athletes - Golditz, Tobias; Steib, Simon; Pfeifer, Klaus; Uder, Michael; Gelse, Kolja; Janka, Rolf Matthias; Hennig, Friedrich; Welsch, Götz (Osteoarthritis and Cartilage, 2014)
Objective: The aim of this study was to investigate, using T2-mapping, the impact of functional instability in the ankle joint on the development of early cartilage damage. Methods: Ethical approval for this study was provided. Thirty-six volunteers from the university sports program were divided into three groups according to their ankle status: functional ankle instability (FAI, initial ankle sprain with residual instability); ankle sprain Copers (initial sprain, without residual instability); and controls (without a history of ankle injuries). Quantitative T2-mapping magnetic resonance imaging (MRI) was performed at the beginning ('early-unloading') and at the end ('late-unloading') of the MR-examination, with a mean time span of 27min. Zonal region-of-interest T2-mapping was performed on the talar and tibial cartilage in the deep and superficial layers. The inter-group comparisons of T2-values were analyzed using paired and unpaired t-tests. Statistical analysis of variance was performed. Results: T2-values showed significant to highly significant differences in 11 of 12 regions throughout the groups. In early-unloading, the FAI-group showed a significant increase in quantitative T2-values in the medial, talar regions (. P=0.008, P=0.027), whereas the Coper-group showed this enhancement in the central-lateral regions (. P=0.05). Especially the comparison of early-loading to late-unloading values revealed significantly decreasing T2-values over time laterally and significantly increasing T2-values medially in the FAI-group, which were not present in the Coper- or control-group. Conclusion: Functional instability causes unbalanced loading in the ankle joint, resulting in cartilage alterations as assessed by quantitative T2-mapping. This approach can visualize and localize early cartilage abnormalities, possibly enabling specific treatment options to prevent osteoarthritis in young athletes.
UnivIS-Import:2015-03-09:Pub.2014.phil.dps.iss.psbg.functi
Keywords: Functional ankle instability; Magnetic resonance imaging; Osteoarthritis; Sports medicine; T2-mapping

Functional Brain Imaging Reveals Rapid Blockade of Abdominal Pain Response Upon Anti-TNF Therapy in Crohn's Disease - Heß, Andreas; Roesch, Julie; Saake, Marc; Sergeeva, Marina; Hirschmann, Simon; Neumann, Helmut; Dörfler, Arnd; Neurath, Markus; Atreya, Raja (Gastroenterology, 2015)
EVALuna2:2003

Functional connectivity reveals altered activation of distinct brain areas in pruritus of cholestasis - Kremer, Andreas; Buchwald, Theresa; Vetter, Marcel; Dörfler, Arnd; Forster, Clemens (JOURNAL OF HEPATOLOGY, 2018)
CRIS-Team WoS Importer:2019-03-26

Functional Long-Term Outcome after Left- versus Right-Sided Intracerebral Hemorrhage - Beuscher, Vanessa D.; Kuramatsu, Joji; Gerner, Stefan; Kohn, Julia; Lücking, Hannes; Kloska, Stephan; Huttner, Hagen (Cerebrovascular Diseases, 2017)
Hemispheric location might influence outcome after intracerebral hemorrhage (ICH). INTERACT suggested higher short-term mortality in right hemispheric ICH, yet statistical imbalances were not addressed. This study aimed at determining the differences in long-term functional outcome in patients with right- vs. left-sided ICH with a priori-defined sub-analysis of lobar vs. deep bleedings.Data from a prospective hospital registry were analyzed including patients with ICH admitted between January 2006 and August 2014. Data were retrieved from institutional databases. Outcome was assessed using the modified Rankin Scale (mRS) score. Outcome measures (long-term mortality and functional outcome at 12 months) were correlated with ICH location and hemisphere, and the imbalances of baseline characteristics were addressed by propensity score matching.A total of 831 patients with supratentorial ICH (429 left and 402 right) were analyzed. Regarding clinical baseline characteristics in the unadjusted overall cohort, there were differences in disfavor of right-sided ICH (antiplatelets: 25.2% in left ICH vs. 34.3% in right ICH; p < 0.01; previous ischemic stroke: 14.7% in left ICH vs. 19.7% in right ICH; p = 0.057; and presence/extent of intraventricular hemorrhage: 45.0% in left ICH vs. 53.0% in right ICH; p = 0.021; Graeb-score: 0 [0-4] in left ICH vs. 1 [0-5] in right ICH; p = 0.017). While there were no differences in mortality and in the proportion of patients with favorable vs. unfavorable outcome (mRS 0-3: 142/375 [37.9%] in left ICH vs. 117/362 [32.3%] in right ICH; p = 0.115), patients with left-sided ICH showed excellent outcome more frequently (mRS 0-1: 64/375 [17.1%] in left ICH vs. 43/362 [11.9%] in right ICH; p = 0.046) in the unadjusted analysis. After adjusting for confounding variables, a well-balanced group of patients (n = 360/hemisphere) was compared showing no differences in long-term functional outcome (mRS 0-3: 36.4% in left ICH vs. 33.9% in right ICH; p = 0.51). Sub-analyses of patients with deep vs. lobar ICH revealed also no differences in outcome measures (mRS 0-3: 53/151 [35.1%] in left deep ICH vs. 53/165 [32.1%] in right deep ICH; p = 0.58).Previously described differences in clinical end points among patients with left- vs. right-hemispheric ICH may be driven by different baseline characteristics rather than by functional deficits emerging from different hemispheric functions affected. After statistical corrections for confounding variables, there was no impact of hemispheric location on functional outcome after ICH.
EVALuna2:22480

Fusion of Preoperative MRI and Postoperative FD-CT for Direct Evaluation of Cochlear Implants: An Analysis at 1.5 T and 3 T - Eisenhut, Felix; Kleibe, Isabella; Hornung, Joachim; Iro, Heinrich; Dörfler, Arnd; Lang, Stefan; Taha, Lava (Clinical Neuroradiology, 2019)
Aim: This study was carried out to evaluate the diagnostic value of merging preoperative magnetic resonance imaging (MRI) with postoperative flat-panel computed tomography (FD-CT) and compare it to standard postoperative FD-CT for assessment of cochlear implant (CI) insertion. Methods: The T2-weighted (T2w) constructive interference in steady state (CISS) data sets of preoperative 1.5 T and 3 T MRI scans of CI patients with both regular and adverse implant spiralization were co-registered with the corresponding postoperative FD-CT data sets using defined anatomic landmarks. These merged FD-CT/MRI volumes (CMV) were compared to the corresponding postoperative FD-CT MPRs in consensus reading with respect to qualitative, i.e. scala tympani spiralization, scala vestibuli spiralization, scalar translocation and quantitative, i.e. distance of the last electrode to the lateral cochlea wall (D1) distance of the 2nd/5th electrode to the basal cochlear wall (D2) and the transition point (TP) of the scalar translocation, parameters. Results: In total 30 patients (n 1.5T MRI = 18 patients; n 3T MRI = 12 patients) were included in the analysis. In all cases both CMVs and FD-CT MPRs were generated. Qualitative analysis of intracochlear CI position with CMVs (both 1.5 T and 3 T) and FD-CT was equivalent: In 20 patients the CI showed a regular implant spiralization, in 10 cases a scalar translocation was identified with both CMVs and FD-CT. Quantitative analysis showed a high level of congruency between CMVs (both 1.5 T and 3T) and FD-CT for fusion accuracy (D1: mean FD-CT D1 = 1.30 ± 0.7 mm; mean CMV D1 = 1.27 ± 0.77 mm, correlation r = 0.94, p < 0.0001; D2: mean FD-CT D2 = 1.17 ± 0.34 mm; mean CMV D2 = 1.10 ± 0.31 mm, correlation r = 0.89, p < 0.0001) and TP of the scalar translocation (mean FD-CT = 126.0 ± 59.25°, mean CMV = 117.0 ± 52.82°, correlation r = 0.95, p < 0.0001). Conclusion: The co-registration of preoperative 1.5 and 3 T MRI with postoperative FD-CT enables a direct evaluation of the position of a CI equivalent to the current standard FD-CT. Despite the fact that CMV provided no additional diagnostic value in this series, regardless whether preoperative 1.5 or 3 T MRI was used for co-registration, it might help to simplify postoperative CI diagnostics.
CRIS-Team Scopus Importer:2019-12-03
Keywords: Cochlear implant; Flat panel computed tomography; Magnetic resonance imaging; Merging; Scalar translocation

Ga-68-FAPI-04 PET/CT for molecular assessment of fibroblast activation and risk evaluation in systemic sclerosis-related interstitial lung disease - Schmidkonz, Christian; Distler, Jörg; Treutlein, Christoph; Atzinger, Armin; Prante, Olaf; Ritt, Philipp; Goetz, T.; Bäuerle, Tobias; Cordes, Michael; Köhner, Markus; Kuwert, Torsten; Ramming, Andreas; et al. (European Journal of Nuclear Medicine and Molecular Imaging, 2021)
CRIS-Team WoS Importer:2022-01-07

Gadolinium-based contrast agents: What we learned from acute adverse events, nephrogenic systemic fibrosis and brain retention - Bäuerle, Tobias; Saake, Marc; Uder, Michael (Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2020)
Background Radiologists have been administering gadolinium-based contrast agents (GBCA) in magnetic resonance imaging for several decades, so that there is abundant experience with these agents regarding allergic-like reactions, nephrogenic systemic fibrosis (NSF) and gadolinium retention in the brain.
CRIS-Team WoS Importer:2021-01-22

Gait, physical activity and tibiofemoral cartilage damage: a longitudinal machine learning analysis in the Multicenter Osteoarthritis Study - Costello, Kerry E.; Felson, David T.; Jafarzadeh, S. Reza; Guermazi, Ali; Roemer, Frank; Segal, Neil A.; Lewis, Cora E.; Nevitt, Michael C.; Lewis, Cara L.; Kolachalama, Vijaya B.; Kumar, Deepak (British Journal of Sports Medicine, 2023)
ObjectiveTo (1) develop and evaluate a machine learning model incorporating gait and physical activity to predict medial tibiofemoral cartilage worsening over 2 years in individuals without advanced knee osteoarthritis and (2) identify influential predictors in the model and quantify their effect on cartilage worsening. DesignAn ensemble machine learning model was developed to predict worsened cartilage MRI Osteoarthritis Knee Score at follow-up from gait, physical activity, clinical and demographic data from the Multicenter Osteoarthritis Study. Model performance was evaluated in repeated cross-validations. The top 10 predictors of the outcome across 100 held-out test sets were identified by a variable importance measure. Their effect on the outcome was quantified by g-computation. ResultsOf 947 legs in the analysis, 14% experienced medial cartilage worsening at follow-up. The median (2.5-97.5th percentile) area under the receiver operating characteristic curve across the 100 held-out test sets was 0.73 (0.65-0.79). Baseline cartilage damage, higher Kellgren-Lawrence grade, greater pain during walking, higher lateral ground reaction force impulse, greater time spent lying and lower vertical ground reaction force unloading rate were associated with greater risk of cartilage worsening. Similar results were found for the subset of knees with baseline cartilage damage. ConclusionsA machine learning approach incorporating gait, physical activity and clinical/demographic features showed good performance for predicting cartilage worsening over 2 years. While identifying potential intervention targets from the model is challenging, lateral ground reaction force impulse, time spent lying and vertical ground reaction force unloading rate should be investigated further as potential early intervention targets to reduce medial tibiofemoral cartilage worsening.
CRIS-Team WoS Importer:2023-03-31

Galactography with Tomosynthesis Technique (Galactomosynthesis) - Renaissance of a Method? - Schulz-Wendtland, Rüdiger; Preuss, Caroline; Fasching, Peter; Löhberg, Christian; Lux, Michael P.; Emons, Julius; Beckmann, Matthias; Uder, Michael; Mueller-Schimpfle, Markus (Geburtshilfe und Frauenheilkunde, 2018)
Introduction: For decades, conventional galactography was the only imaging technique capable of showing the mammary ducts. Today, diagnosis is based on a multimodal concept which combines high-resolution ultrasound with magnetic resonance (MR) mammography and ductoscopy/galactoscopy and has a sensitivity and specificity of up to 95%. This study used tomosynthesis in galactography for the first time and compared the synthetic digital 2D full-field mammograms generated with this technique with the images created using the established method of ductal sonography. Both methods should be able to detect invasive breast cancers and their precursors such as ductal carcinoma in situ (DCIS) as well as being able to identify benign findings. Material and Methods: Five patients with pathological nipple discharge were examined using ductal sonography, contrast-enhanced 3D galactography with tomosynthesis and the synthetic digital 2D full-field mammograms generated with the latter method. Evaluation of the images created with the different imaging modalities was done by three investigators with varying levels of experience with complementary breast diagnostics (1, 5 and 15 years), and their evaluations were compared with the histological findings. Results: All 3 investigators independently evaluated the images created with ductal sonography, contrast-enhanced 3D galactography with tomosynthesis, and generated synthetic digital 2D full-field mammograms. Their evaluations were compared with the histopathological assessment of the surgical specimens resected from the 5 patients. There was 1 case of invasive breast cancer, 2 cases with ductal carcinoma in situ and 2 cases with benign findings. All 3 investigators made more mistakes when they used the standard imaging technique of ductal sonography to diagnose suspicious lesions than when they used contrast-enhanced galactography with tomosynthesis and the generated synthetic digital 2D full-field mammograms. Conclusion: This is the first time breast tomosynthesis was used in galactography (galactomosynthesis) to create digital 3-dimensional images of suspicious findings. When used together with the generated synthetic digital 2D full-field mammograms, it could be a useful complementary procedure for the diagnosis of breast anomalies and could herald a renaissance of this method. Compared with high-resolution ductal ultrasound, the investigators achieved better results with contrast-enhanced galactography using tomosynthesis and the generated synthetic digital 2D full-field mammograms, as confirmed by histopathological findings.
EVALuna2:34697

Generation and characterization of hepatocellular carcinoma cell lines with enhanced cancer stem cell potential - Muenzner, Julienne K.; Kunze, Philipp; Lindner, Pablo; Polaschek, Sandra; Menke, Kira; Eckstein, Markus; Geppert, Carol-Immanuel; Chanvorachote, Pithi; Bäuerle, Tobias; Hartmann, Arndt; Schneider-Stock, Regine (Journal of Cellular and Molecular Medicine, 2018)
Hepatocellular carcinoma (HCC) is one of the most common causes for cancer-related death worldwide with rapidly increasing incidence and mortality rates. As for other types of cancers, also in HCC cancer stem cells (CSCs) are thought to be responsible for tumour initiation, progression and therapy failure. However, as rare subpopulations of tumour tissue, CSCs are difficult to isolate, thus making the development of suitable and reliable model systems necessary. In our study, we generated HepG2 subclones with enriched CSC potential by application of the spheroid formation method and subsequent single-cell cloning. Analyses in several 2D and 3D cell culture systems as well as a panel of functional assays both in vitro and in vivo revealed that the generated subclones displayed characteristic and sustained features of tumour initiating cells as well as highly aggressive properties related to tumour progression and metastasis. These characteristics could clearly be correlated with the expression of CSC markers that might have prognostic value in the clinical HCC setting. Therefore, we conclude that our CSC enriched HepG2 clones certainly represent suitable model systems to study the role of CSCs during HCC initiation, progression and drug resistance.
EVALuna2:34899

Genomic EWSR1 Fusion Sequence as Highly Sensitive and Dynamic Plasma Tumor Marker in Ewing Sarcoma - Krumbholz, Manuela; Hellberg, Julia; Steif, Benedikt; Bäuerle, Tobias; Gillmann, Clarissa; Fritscher, Torsten; Agaimy, Abbas; Frey, Benjamin; Juengert, Joerg; Wardelmann, Eva; Hartmann, Wolfgang; Juergens, Heribert; et al. (Clinical Cancer Research, 2016)
The application of the tumor-specific genomic fusion sequence as noninvasive biomarker for therapy monitoring in Ewing sarcoma (EwS) has been evaluated.EwS xenograft mouse models were used to explore detectability in small plasma volumes and correlation of genomic EWSR1-FLI1 copy numbers with tumor burden. Furthermore, 234 blood samples from 20 EwS patients were analyzed before and during multimodal treatment. EWSR1 fusion sequence levels in patients' plasma were quantified using droplet digital PCR and compared with tumor volumes calculated from MRI or CT imaging studies.Kinetics of EWSR1 fusion sequence copy numbers in the plasma are correlated with changes of the tumor volume in patients with localized and metastatic disease. The majority of patients showed a fast reduction of cell-free tumor DNA (ctDNA) during initial chemotherapy. Recurrence of increasing ctDNA levels signalized relapse development.Genomic fusion sequences represent promising noninvasive biomarkers for improved therapy monitoring in EwS. Until now, response assessment is largely based on MRI and CT imaging, implying restrictions on closely repeated performance and limitations on the differentiation between vital tumor and reactive stromal tissue. Particularly in patients with prognostic unfavorable disseminated disease, ctDNA is a valuable addition for the assessment of therapy response. Clin Cancer Res; 22(17); 4356-65. ©2016 AACR.
EVALuna2:6851

Germany’s journey toward 14 Tesla human magnetic resonance - Ladd, Mark E.; Quick, Harald H.; Speck, Oliver; Bock, Michael; Dörfler, Arnd; Forsting, Michael; Hennig, Jürgen; Ittermann, Bernd; Möller, Harald E.; Nagel, Armin M.; Niendorf, Thoralf; Remy, Stefan; et al. (Magnetic Resonance Materials in Physics Biology and Medicine, 2023)
Multiple sites within Germany operate human MRI systems with magnetic fields either at 7 Tesla or 9.4 Tesla. In 2013, these sites formed a network to facilitate and harmonize the research being conducted at the different sites and make this technology available to a larger community of researchers and clinicians not only within Germany, but also worldwide. The German Ultrahigh Field Imaging (GUFI) network has defined a strategic goal to establish a 14 Tesla whole-body human MRI system as a national research resource in Germany as the next progression in magnetic field strength. This paper summarizes the history of this initiative, the current status, the motivation for pursuing MR imaging and spectroscopy at such a high magnetic field strength, and the technical and funding challenges involved. It focuses on the scientific and science policy process from the perspective in Germany, and is not intended to be a comprehensive systematic review of the benefits and technical challenges of higher field strengths.
CRIS-Team Scopus Importer:2023-04-21
Keywords: 14T; Extremely high field; GUFI; MRI; Ultrahigh field

Glaucoma classification based on histogram analysis of diffusion tensor imaging measures in the optic radiation - El-Rafei, Ahmed Mohamed Ibrahim; Engelhorn, Tobias; Wärntges, Simone; Dörfler, Arnd; Hornegger, Joachim; Michelson, Georg (Springer-verlag, 2011)
Glaucoma is associated with axonal degeneration of the optic nerve leading to visual impairment. This impairment can progress to a complete vision loss. The transsynaptic disease spread in glaucoma extends the degeneration process to different parts of the visual pathway. Most of glaucoma diagnosis focuses on the eye analysis, especially in the retina. In this work, we propose a system to classify glaucoma based on visual pathway analysis. The system utilizes diffusion tensor imaging to identify the optic radiation. Diffusion tensor-derived indices describing the underlying fiber structure as well as the main diffusion direction are used to characterize the optic radiation. Features are extracted from the histograms of these parameters in regions of interest defined on the optic radiation. A support vector machine classifier is used to rank the extracted features according to their discrimination ability between glaucoma patients and healthy subjects. The seven highest ranked features are used as inputs to a logistic regression classifier. The system is applied to two age-matched groups of 39 glaucoma subjects and 27 normal controls. The evaluation is performed using a 10-fold cross validation scheme. A classification accuracy of 81.8% is achieved with an area under the ROC curve of 0.85. The performance of the system is competitive to retina based classification systems. However, this work presents a new direction in detecting glaucoma using visual pathway analysis. This analysis is complementary to eye examinations and can result in improvements in glaucoma diagnosis, detection, and treatment. © 2011 Springer-Verlag.

Glaucoma classification based on visual pathway analysis using diffusion tensor imaging - El-Rafei, Ahmed Mohamed Ibrahim; Engelhorn, Tobias; Wärntges, Simone; Dörfler, Arnd; Hornegger, Joachim; Michelson, Georg (Magnetic Resonance Imaging, 2013)
Most of the existing methods for diagnosing glaucoma analyze the eye with a main focus on the retina, despite the transsynaptic nature of the fiber degeneration caused by glaucoma. Thus, they ignore a significant part of the visual system represented by the visual pathway in the brain. The advances in neuroimaging, especially diffusion tensor imaging (DTI), enable the identification and characterization of white matter fibers. In this work, we propose a system based on DTI analysis of the visual pathway fibers in the optic radiation for detecting and discriminating different glaucoma entities. The optic radiation is identified semi-automatically. DTI provides information about the fiber orientation as well as a set of derived parameters describing the degree of diffusion anisotropy and diffusivity. Features for each DTI derived measure are extracted from a specified region of interest on the optic radiation. The features are grouped into three sets: Histogram, co-occurrence matrices, and Laws features. For feature selection, the features are ranked using a support vector machine classifier. The highest ranked features are used for classification. A support vector machine classifier is used for classification in a 10-fold cross validation setup. The system is applied to three age-matched subjects' categories containing 27 healthy, 39 primary open angle glaucoma (POAG), and 18 normal tension glaucoma (NTG) subjects. The discrimination accuracy between healthy and glaucoma (POAG and NTG) subjects is 94.1% with an area under the ROC of 0.97. Classification accuracy of 92.4% is obtained for the normal and the POAG groups while it increased to 100% in case of healthy and NTG groups. In addition, the system could differentiate between glaucoma types (POAG and NTG) with an accuracy of 98.3%. A complementary analysis was performed to estimate the selection bias in the obtained accuracy. The bias ranged from 10% to 20% depending on the group pair under consideration. The classification results indicate the high performance of the system compared to retina-based glaucoma detection systems. The proposed approach utilizes visual pathway analysis rather than the conventional eye analysis which presents a new trend in glaucoma detection. Analyzing the entire visual system could provide significant information that can improve the glaucoma examination flow and treatment. (c) 2013 Elsevier Inc. All rights reserved.
Keywords: Diffusion tensor imaging; Glaucoma; Optic radiation; Visual pathway; Classification; Texture features

Glucocorticoid-induced relapse of COVID-19 in a patient with sarcoidosis - Györfi, Andrea-Hermina; Kopp, Markus; May, Matthias; Vetter, Marcel; Uder, Michael; Kremer, Andreas; Schett, Georg; Harrer, Thomas; Distler, Jörg (Annals of the Rheumatic Diseases, 2020)
CRIS-Team Scopus Importer:2020-11-20

Grehlin concentrations correlate with hunger and craving ratings following oral ingestion of macronutrients - Thürauf, Norbert; Bachlechner, Stephan; Denzer-Lippmann, Melanie; Wielopolski, Jan; Fischer, Marie; Büttner, Andrea; Dörfler, Arnd; Schöfl, Christof; Muench, Gerald; Kornhuber, Johannes (CHEMICAL SENSES, 2019)
CRIS-Team WoS Importer:2019-03-26

Guided Noise Reduction for Spectral CT with Energy-Selective Photon Counting Detectors - Manhart, Michael; Fahrig, Rebecca; Hornegger, Joachim; Dörfler, Arnd; Maier, Andreas (Proceedings of the Third CT Meeting, 2014)
UnivIS-Import:2015-04-16:Pub.2014.tech.IMMD.IMMD5.guided_6

Guided Noise Reduction with Streak Removal for High Speed Flat Detector CT Perfusion - Manhart, Michael; Aichert, André; Kowarschik, Markus; Deuerling-Zheng, Yu; Struffert, Tobias; Dörfler, Arnd; Maier, Andreas; Hornegger, Joachim (Proceedings NSS/MIC 2013, 2013)
Tissue perfusion measurement using C-arm angiography systems capable of CT-like imaging (flat detector CT (FD-CT)) is a novel technique with high potential benefit for catheter-guided treatment of stroke in the interventional suite. New high speed protocols (HSP) with increased C-arm rotation speed enable fast acquisitions of FD-CT volumes and allow for sampling the contrast flow with improved temporal resolution. However, the peak contrast attenuation values of brain tissue typically lie in a range of 5-30 HU. Thus perfusion imaging is very sensitive to noise. Recently we introduced the FDK-JBF denoising technique based on Feldkamp (FDK) reconstruction followed by denoising in volume space using joint bilateral filtering (JBF). In the evaluation FDK-JBF achieved comparable results to algebraic techniques, but is computationally less costly. Yet the angular sampling of the projection data in the HSP is coarse, which leads to streak artifacts in the reconstructed volumes. Mask volumes are subtracted from the contrast agent enhanced (bolus) volumes and the streak artifacts are subtracted out if the patient does not move during the acquisition. However, in case of motion the streak artifacts will not be identical in the mask and bolus volumes. We show that these streaks can lead to severe artifacts in the perfusion maps and describe a novel technique for streak removal (SR), which is based on streak detection by using time-contrast curve analysis.We evaluated the FDK-SR-JBF algorithm in a phantom and a patient study and show that noise and streaks can be reduced within a short computation time. © 2013 IEEE.
UnivIS-Import:2015-04-16:Pub.2013.tech.IMMD.IMMD5.guided_5
Keywords: Flat detector CT; noise reduction; Perfusion imaging; stroke treatment

Haptic Rendering of Soft-Tissue for Training Surgical Procedures at the Larynx - Eixelberger, Thomas; Parchent, Jonas; Janka, Rolf Matthias; Stamminger, Marc; Döllinger, Michael; Wittenberg, Thomas (Bildverarbeitung für die Medizin 2020, Informatik aktuell, 2020)

Heart Failure in Ischemic Stroke: Relevance for Acute Care and Outcome - Siedler, Gabriela; Sommer, Kim; Macha, Kosmas; Marsch, Armin; Breuer, Lorenz; Stoll, Svenja; Engelhorn, Tobias; Dörfler, Arnd; Schwab, Stefan; Kallmünzer, Bernd; Arnold, Martin (Stroke, 2019)
Background and Purpose- Heart failure (HF) in patients with acute ischemic stroke constitutes the source of various detrimental pathophysiologic mechanisms including prothrombotic and proinflammatory states, worsening of cerebral tissue oxygenation, and hemodynamic impairment. In addition, HF might affect the safety and efficacy of the acute recanalization stroke therapies. Methods- Patients treated with intravenous recombinant tissue-type plasminogen activator or mechanical recanalization at a universitary stroke center were included into a prospective registry. Patients received cardiological evaluation, including echocardiography, during acute care. Functional outcome was assessed after 90 days by structured telephone interviews. Safety and efficacy of intravenous thrombolysis and mechanical thrombectomy were investigated among patients with HF and compared with patients with normal cardiac function after propensity score matching. Results- One thousand two hundred nine patients were included. HF was present in 378 patients (31%) and an independent predictor of unfavorable functional outcome. Recanalization rates were equal among patients with HF after intravenous thrombolysis and after mechanical recanalization or combined treatment. The rate of secondary intracranial hemorrhage was not different (7% versus 8%; P=0.909 after thrombolysis and 15% versus 20%, P=0.364 after mechanical recanalization or combined therapy). Early mortality within 48 hours after admission was equal (<1.5% in both groups). Conclusions- In this real-world cohort of patients with stroke, HF was an independent predictor of unfavorable functional long-term outcome, while the safety and efficacy of intravenous thrombolysis and mechanical recanalization appeared unaffected.
EVALuna2:204477

Heberden's Nodes and Knee Osteoarthritis–Related Osseous Structural Damage: Exploratory Study From the Osteoarthritis Initiative - Haj-Mirzaian, Arya; Mohajer, Bahram; Guermazi, Ali; Shakoor, Delaram; Haugen, Ida K.; Roemer, Frank; Demehri, Shadpour (Arthritis and Rheumatology, 2019)
Objective: To explore whether Heberden's nodes (HNs) could predict magnetic resonance imaging (MRI)–based knee osteoarthritis (OA)–related osseous structural progression. Methods: Five hundred seventy-five subjects from the Foundation for the National Institutes of Health project underwent clinical examination to evaluate HNs at baseline and knee MRI at baseline and 24 months. The MRI was read according to the semiquantitative MRI OA Knee Score and quantitative periarticular bone morphology measures. Adjusted linear/logistic regression models were implemented to assess the association between the presence of HNs at baseline examination and worsening of MRI-defined osseous structural damage, and odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. Results: Comparing patients with HNs (n = 395) and patients without HNs (n = 180), more periarticular bone area expansion in the knee joint was seen in the patients with HNs over 24 months (adjusted OR [OR adj ] 1.39 [95% CI 1.06, 1.83], corrected P [P corr ] = 0.019), especially in the medial femur (OR adj 1.49 [95% CI 1.05, 2.13], P corr = 0.026) and lateral femur (OR adj 2.51 [95% CI 1.58, 3.97], P corr < 0.001), femoral notch (OR adj 1.37 [95% CI 1.02, 1.84], P corr = 0.04), and lateral trochlea (OR adj 1.44 [95% CI 1.08, 1.9], P corr = 0.012). However, a trend toward less osteophyte worsening was seen in patients with HNs in the whole knee joint (OR adj 0.63 [95% CI 0.40, 1.02], P corr = 0.058), particularly in the femur region (OR adj 0.54 [95% CI 0.31, 0.95], P corr = 0.03), compared to patients without HNs. Conclusion: The presence of HNs was associated with increased MRI-based periarticular bone area expansion, but less osteophyte worsening over 24 months in the knee joint, especially in the femoral region.
CRIS-Team Scopus Importer:2019-05-02

Heberden’s nodes and their association with mri-based knee osteoarthritis: exploratory study from the foundation for the national institutes of health study - Haj-Mirzaian, A.; Mohajer, B.; Guermazi, A.; Shakoor, D.; Haugen, I.; Roemer, Frank; Demehri, S. (OSTEOARTHRITIS AND CARTILAGE, 2019)
CRIS-Team WoS Importer:2019-05-21

Hematoma Characteristics and Functional Outcome Do Not Differ in NOAC- Versus VKA-Associated Intracerebral Hemorrhage - Gerner, Stefan; Lücking, Hannes; Köhrmann, Martin; Huttner, Hagen (2016)
EVALuna2:22585

Hematoma enlargement characteristics in deep versus lobar intracerebral hemorrhage - Sembill, Jochen; Kuramatsu, Joji; Gerner, Stefan; Sprügel, Maximilian; Röder, Sebastian; Madžar, Dominik; Hagen, Manuel; Lücking, Hannes; Dörfler, Arnd; Schwab, Stefan; Huttner, Hagen; Hölter, Philip (Annals of Clinical and Translational Neurology, 2020)
Objective: Hematoma enlargement (HE) is associated with clinical outcomes after supratentorial intracerebral hemorrhage (ICH). This study evaluates whether HE characteristics and association with functional outcome differ in deep versus lobar ICH. Methods: Pooled analysis of individual patient data between January 2006 and December 2015 from a German-wide cohort study (RETRACE, I + II) investigating ICH related to oral anticoagulants (OAC) at 22 participating centers, and from one single-center registry (UKER-ICH) investigating non-OAC-ICH patients. Altogether, 1954 supratentorial ICH patients were eligible for outcome analyses, which were separately conducted or controlled for OAC, that is, vitamin-K-antagonists (VKA, n = 1186) and non-vitamin-K-antagonist-oral-anticoagulants (NOAC, n = 107). Confounding was addressed using propensity score matching, cox regression modeling and multivariate modeling. Main outcomes were occurrence, extent, and timing of HE (>33%/>6 mL) and its association with 3-month functional outcome. Results: Occurrence of HE was not different after deep versus lobar ICH in patients with non-OAC-ICH (39/356 [11.0%] vs. 36/305 [11.8%], P = 0.73), VKA-ICH (249/681 [36.6%] vs. 183/505 [36.2%], P = 0.91), and NOAC-ICH (21/69 [30.4%] vs. 12/38 [31.6%], P = 0.90). HE extent did not differ after non-OAC-ICH (deep:+59% [40–122] vs. lobar:+74% [37–124], P = 0.65), but both patients with VKA-ICH and NOAC-ICH showed greater HE extent after deep ICH [VKA-ICH, deep: +94% [54–199] vs. lobar: +56% [35–116], P < 0.001; NOAC-ICH, deep: +74% [56–123] vs. lobar: +40% [21–49], P = 0.001). Deep compared to lobar ICH patients had higher HE hazard during first 13.5 h after onset (Hazard ratio [HR]: 1.85 [1.03–3.31], P = 0.04), followed by lower hazard (13.5–26.5 h, HR: 0.46 [0.23–0.89], P = 0.02), and equal hazard thereafter (HR: 0.96 [0.56–1.65], P = 0.89). Odds ratio for unfavorable outcome was higher after HE in deep (4.31 [2.71–6.86], P < 0.001) versus lobar ICH (2.82 [1.71–4.66], P < 0.001), and only significant after small-medium (1st volume-quarter, deep: 3.09 [1.52–6.29], P < 0.01; lobar: 3.86 [1.35–11.04], P = 0.01) as opposed to large-sized ICH (4th volume-quarter, deep: 1.09 [0.13–9.20], P = 0.94; lobar: 2.24 [0.72–7.04], P = 0.17). Interpretation: HE occurrence does not differ among deep and lobar ICH. However, compared to lobar ICH, HE after deep ICH is of greater extent in OAC-ICH, occurs earlier and may be of greater clinical relevance. Overall, clinical significance is more apparent after small–medium compared to large-sized bleedings.
CRIS-Team Scopus Importer:2020-03-17

Hemodialysis Patients with Cardiovascular Disease Reveal Increased Tissue Na+ Deposition - Friedrich, Anna Carolina; Linz, Peter; Nagel, Armin Michael; Rosenhauer, Daniela; Horn, Stephan; Schiffer, Mario; Uder, Michael; Kopp, Christoph; Dahlmann, Anke (Kidney & Blood Pressure Research, 2022)
BACKGROUND: The relationship between Na+ balance and cardiovascular disease (CVD) in hemodialysis (HD) patients is not yet fully understood. We hypothesized that HD patients co-diagnosed with CVD show increased tissue Na+ accumulation compared to HD patients without CVD. METHODS: In our observational study, 52 HD patients were divided into a group with (23 subjects) or without (29 subjects) a positive history of cardiovascular events. We used 23Na-magnetic resonance imaging (23Na-MRI) at 3.0 Tesla to quantify Na+ content in skin and muscle of both groups directly before and after HD. Additionally, total body fluid distribution was determined by bioimpedance spectroscopy (BIS) and laboratory parameters were assessed. RESULTS: Compared to HD patients without CVD, 23Na-MRI detected an increased Na+ content in skin (21.7 ± 7.3 vs. 30.2 ± 9.8 arbitrary units (a.u.), p < 0.01) and muscle tissue (21.5 ± 3.6 vs. 24.7 ± 6.0 a.u., p < 0.05) in patients with previous CVD events. Simultaneously measured fluid amount by BIS, includingexcess extracellular water (1.8 ± 1.7 vs. 2.2 ± 1.7 L, p = 0.44), was not significantly different between both groups. Tissue Na+ accumulation in HD-CVD patients was paralleled by a higher plasma concentration of the inflammation marker interleukin-6 (5.1, IQR 5.8 vs. 8.5, IQR 7.9 pg/mL, p < 0.05). CONCLUSION: In our cohort, HD patients with CVD showed higher tissue Na+ content than HD patients without CVD, while no difference in body water distribution could be detected between both groups. Our findings provide evidence that the history of a cardiovascular event is associated with disturbances in tissue Na+ content in HD patients.
CRIS-Team Scopus Importer:2022-03-25
Keywords: 23Na-magnetic resonance imaging; Cardiovascular disease; Hemodialysis; Tissue Na+

Heparin for prophylaxis of venous thromboembolism in intracerebral haemorrhage - Sprügel, Maximilian; Sembill, Jochen; Kuramatsu, Joji; Gerner, Stefan; Hagen, Manuel; Röder, Sebastian; Endres, Matthias; Haeusler, Karl Georg; Sobesky, Jan; Schurig, Johannes; Zweynert, Sarah; Bauer, Miriam; et al. (Journal of Neurology Neurosurgery and Psychiatry, 2019)
Objective: To determine the occurrence of intracranial haemorrhagic complications (IHC) on heparin prophylaxis (low-dose subcutaneous heparin, LDSH) in primary spontaneous intracerebral haemorrhage (ICH) (not oral anticoagulation-associated ICH, non-OAC-ICH), vitamin K antagonist (VKA)-associated ICH and non-vitamin K antagonist oral anticoagulant (NOAC)-associated ICH. Methods: Retrospective cohort study (RETRACE) of 22 participating centres and prospective single-centre study with 1702 patients with VKA-associated or NOAC-associated ICH and 1022 patients with non-OAC-ICH with heparin prophylaxis between 2006 and 2015. Outcomes were defined as rates of IHC during hospital stay among patients with non-OAC-ICH, VKA-ICH and NOAC-ICH, mortality and functional outcome at 3 months between patients with ICH with and without IHC. Results: IHC occurred in 1.7% (42/2416) of patients with ICH. There were no differences in crude incidence rates among patients with VKA-ICH, NOAC-ICH and non-OAC-ICH (log-rank p=0.645; VKA-ICH: 27/1406 (1.9%), NOAC-ICH 1/130 (0.8%), non-OAC-ICH 14/880 (1.6%); p=0.577). Detailed analysis according to treatment exposure (days with and without LDSH) revealed no differences in incidence rates of IHC per 1000 patient-days (LDSH: 1.43 (1.04-1.93) vs non-LDSH: 1.32 (0.33-3.58), conditional maximum likelihood incidence rate ratio: 1.09 (0.38-4.43); p=0.953). Secondary outcomes showed differences in functional outcome (modified Rankin Scale=4-6: IHC: 29/37 (78.4%) vs non-IHC: 1213/2048 (59.2%); p=0.019) and mortality (IHC: 14/37 (37.8%) vs non-IHC: 485/2048 (23.7%); p=0.045) in disfavour of patients with IHC. Small ICH volume (OR: volume <4.4 mL: 0.18 (0.04-0.78); p=0.022) and low National Institutes of Health Stroke Scale (NIHSS) score on admission (OR: NIHSS <4: 0.29 (0.11-0.78); p=0.014) were significantly associated with fewer IHC. Conclusions: Heparin administration for venous thromboembolism (VTE) prophylaxis in patients with ICH appears to be safe regarding IHC among non-OAC-ICH, VKA-ICH and NOAC-ICH in this observational cohort analysis. Randomised controlled trials are needed to verify the safety and efficacy of heparin compared with other methods for VTE prevention.
CRIS-Team Scopus Importer:2019-05-02
Keywords: cerebrovascular disease; critical care; intracerebral heamorrhage; stroke

HERZ THORAX – Regionale Lungenfunktion bei Lymphangioleiomyomatose mit der MRT diagnostizieren - May, Matthias (Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2022)
CRIS-Team Scopus Importer:2022-10-21

HETEROGENEITY OF CARTILAGE INVOLVEMENT IN KNEES WITH RADIOGRAPHIC DISEASE SEVERITY KELLGREN-LAWRENCE 2 AND 3: THE MOST STUDY - Roemer, Frank; Felson, D. T.; Stefanik, J. J.; Rabasa, G.; Crema, M. D.; Wang, N.; Neogi, T.; Lynch, J. A.; Nevitt, M. C.; Torner, J.; Lewis, C. E.; Guermazi, A. (OSTEOARTHRITIS AND CARTILAGE, 2021)
CRIS-Team WoS Importer:2021-05-21

HETEROGENOUS CARTILAGE DAMAGE SEEN ON MRI AMONG KNEES WITH KELLGREN-LAWRENCE 2 & 3 OSTEOARTHRITIS: WHAT ARE THE IMPLICATIONS FOR CLINICAL TRIALS? - Jarraya, M.; Roemer, Frank; Ashbeck, E.; Lynch, J.; Kwoh, C. K.; Guermazi, A. (ANNALS OF THE RHEUMATIC DISEASES, 2022)
CRIS-Team WoS Importer:2022-11-04

High Detection Accuracy of an optimized 3D Convolutional Neural Network for Auto Detection and Auto Segmentation of Brain Metastases - Putz, Florian; Weissmann, Thomas; Mansoorian, Sina; Schmitter, Charlotte; Semrau, Sabine; Lettmaier, Sebastian; Masitho, Siti; Grigo, Johanna; Schmidt, Manuel; Heiß, Rafael; Frey, Benjamin; Bert, Christoph; et al. (STRAHLENTHERAPIE UND ONKOLOGIE, 2021)
CRIS-Team WoS Importer:2021-07-16

High fat diet increases melanoma cell growth in the bone marrow by inducing osteopontin and interleukin 6 - Chen, Guangliang; Luo, Yubin; Eriksson, Daniel; Meng, Xianyi; Qian, Cheng; Bäuerle, Tobias; Chen, Xiao-Xiang; Schett, Georg; Bozec, Aline (Oncotarget, 2016)
The impact of metabolic stress induced by obesity on the bone marrow melanoma niche is largely unknown. Here we employed diet induced obese mice model, where mice received high-fat (HFD) or normal diet (ND) for 6 weeks before challenge with B16F10 melanoma cells. Tumor size, bone loss and osteoclasts numbers were assessed histologically in the tibial bones. For defining the molecular pathway, osteopontin knock-out mice, interleukin 6 neutralizing antibody or Janus kinase 2 inhibition were carried out in the same model. Mechanistic studies such as adipocyte-melanoma co-cultures for defining adipocyte induced changes of tumor cell proliferation and expression profiles were also performed. As results, HFD enhanced melanoma burden in bone by increasing tumor area and osteoclast numbers. This process was associated with higher numbers of bone marrow adipocytes expressing IL-6 in direct vicinity to tumor cells. Inhibition of IL-6 or of downstream JAK2 blocked HFD-induced tumor progression. Furthermore, the phenotypic changes of melanoma cells triggered macrophage and osteoclast accumulation accompanied by increased osteopontin expression. Osteopontin triggered osteoclastogenesis and also exerted a positive feedback loop to tumor cells, which was abrogated in its absence. Metabolic stress by HFD promotes melanoma growth in the bone marrow by an increase in bone marrow adipocytes and IL-6-JAK2-osteopontin mediated activation of tumor cells and osteoclast differentiation.
EVALuna2:13267

High Intensity Resistance Exercise Training vs. High Intensity (Endurance) Interval Training to Fight Cardiometabolic Risk Factors in Overweight Men 30-50 Years Old. - Tuttor, Michael; von Stengel, Simon; Kohl, Matthias; Lell, Michael; Scharf, Michael; Uder, Michael; Wittke, Andreas; Kemmler, Wolfgang (Frontiers in Sports and Active Living, 2020)
Cardiovascular and cardiometabolic diseases are leading causes of death worldwide. Exercise favorably affects this problem, however only few invest (enough) time to favorably influence cardiometabolic risk-factors and cardiac morphology/performance. Time-effective, high-intensity, low-volume exercise protocols might increase people's commitment to exercise. To date, most research has focused on high-intensity interval training (HIIT), the endurance type of HIT, while corresponding HIT-resistance training protocols (HIT-RT) are rarely evaluated. In this study we compared the effect of HIIT vs. HIT-RT, predominately on cardiometabolic and cardiac parameters in untrained, overweight-obese, middle-aged men. Eligible, untrained men aged 30-50 years old in full-time employment were extracted from two joint exercise studies that randomly assigned participants to a HIIT, HIT-RT or corresponding control group. HIIT predominately consisted of interval training 90 s-12 min, (2-4 sessions/week), HIT-RT (2-3 sessions/week) was applied as a single set resistance training to muscular failure. Core intervention length of both protocols was 16 weeks. Main inclusion criteria were overweight-obese status (BMI 25-35 kg/m2) and full employment (occupational working time: ≥38.5 h/week). Primary study-endpoint was the Metabolic Syndrome (MetS) Z-Score, secondary study-endpoints were ventricular stroke volume index (SVI) and myocardial mass index (MMI) as determined by Magnetic Resonance Imaging. The Intention to treat (ITT) principle was applied to analyze the summarized data set. Twenty-seven eligible men of the HIT-RT and 30 men of the HIIT group were included in the ITT. Both interventions significantly (p < 0.001) improve the MetS Z-Score, however the effect of HIIT was superior (p = 0.049). In parallel, HIT-RT and HIIT significantly affect SVI and MMI, with the effect of HIIT being much more pronounced (p < 0.001). Although HIIT endurance exercise was superior in favorably affecting cardiometabolic risk and particularly cardiac performance, both exercise methods positively affect cardiometabolic risk factors in this overweight to obese, middle-aged cohort of males with low time resources. Thus, the main practical application of our finding might be that in general overweight-obese people can freely choose their preferred exercise type (HIIT-END or HIT-RT) to improve their cardiometabolic health, while investing an amount of time that should be feasible for everybody. Trial Registrations: NCT01406730, NCT01766791.
EVALuna2:423136

High-Intensity (Strength) Training (HIT) and Osteoporosis Randomized Controlled Franconian Osteopenia and Sarcopenia Study (FrOST) - Kemmler, Wolfgang; von Stengel, Simon (Bewegungstherapie und Gesundheitssport, 2022)
Consistently supervised, competently guided and carefully constructed HIT-KT with modern strength equipment can be regarded as a safe, attractive, time-saving and effective training method for improving bone density in a group of independently living older men with osteosarcopenia.
CRIS-Team WoS Importer:2022-08-26

High Kellgren-Lawrence Grade and Bone Marrow Lesions Predict Worsening Rates of Radiographic Joint Space Narrowing; The SEKOIA Study - Edwards, Mark H.; Parsons, Camille; Bruyere, Olivier; Dop, Forence Petit; Chapurlat, Roland; Roemer, Frank; Guermazi, Ali; Zaim, Souhil; Genant, Harry; Reginster, Jean-Yves; Dennison, Elaine M.; Cooper, Cyrus (Journal of Rheumatology, 2016)
Determinants of radiographic progression in osteoarthritis (OA) are poorly understood. We investigated which features on baseline magnetic resonance imaging (MRI) acted as predictors of change in joint space width (JSW).A total of 559 men and women over the age of 50 years with clinical knee OA [Kellgren-Lawrence (KL) grade 2-3] were recruited to the placebo arm of the SEKOIA study (98 centers; 18 countries). Minimal tibiofemoral joint space and KL grade on plain radiograph of the knee were assessed at baseline and at yearly followup up to 3 years. In a subset, serial knee MRI examinations were performed. Individuals with a bone marrow lesion (BML) >= grade 2 at the tibiofemoral joint at baseline were classified as BML-positive. Relationships between change in JSW and risk factors were assessed using linear regression.The mean age of study participants was 62.8 (SD 7.5) years and 73% were female; 38.6% had BML. Mean baseline JSW was 3.65 mm. This reduced by 0.18 (0.30) mm/year in men and 0.13 (0.23) mm/year in women. Those with BML had a significantly higher rate of annualized change in JSW; this relationship remained robust after adjustment for age, sex, and baseline KL grade [? = -0.10 (95% CI -0.18, -0.02) mm/yr]. Age, sex, baseline KL grade, and other MRI findings did not influence the rate of change in JSW.The rate of change in JSW was similar in men and women. BML on knee MRI predicted the rate of radiographic change in JSW. This relationship was independent of age, sex, and baseline KL grade.
EVALuna2:10910

Highly accelerated, Dixon-based non-contrast MR angiography versus high-pitch CT angiography - Zeilinger, Martin; Giese, Daniel; Schmidt, Michaela; May, Matthias; Janka, Rolf Matthias; Heiß, Rafael; Ammon, Fabian; Achenbach, Stephan; Uder, Michael; Treutlein, Christoph (Radiologia Medica, 2023)
Objectives: To compare a novel, non-contrast, flow-independent, 3D isotropic magnetic resonance angiography (MRA) sequence that combines respiration compensation, electrocardiogram (ECG)-triggering, undersampling, and Dixon water-fat separation with an ECG-triggered aortic high-pitch computed tomography angiography (CTA) of the aorta. Materials and methods: Twenty-five patients with recent CTA were scheduled for non-contrast MRA on a 3 T MRI. Aortic diameters and cross-sectional areas were measured on MRA and CTA using semiautomatic measurement tools at 11 aortic levels. Image quality was assessed independently by two radiologists on predefined aortic levels, including myocardium, proximal aortic branches, pulmonary veins and arteries, and the inferior (IVC) and superior vena cava (SVC). Image quality was assessed on a 5-point Likert scale. Results: All datasets showed diagnostic image quality. Visual grading was similar for MRA and CTA regarding overall image quality (0.71), systemic arterial image quality (p = 0.07–0.91) and pulmonary artery image quality (p = 0.05). Both readers favored MRA for SVC and IVC, while CTA was preferred for pulmonary veins (all p < 0.05). No significant difference was observed in aortic diameters or cross-sectional areas between native MRA and contrast-enhanced CTA (p = 0.08–0.94). Conclusion: The proposed non-contrast MRA enables robust imaging of the aorta, its proximal branches and the pulmonary arteries and great veins with image quality and aortic diameters and cross-sectional areas comparable to that of CTA. Moreover, this technique represents a suitable free-breathing alternative, without the use of contrast agents or ionizing radiation. Therefore, it is especially suitable for patients requiring repetitive imaging.
CRIS-Team Scopus Importer:2023-12-08
Keywords: Angiography; Computed tomography; Follow-up studies; Magnetic resonance imaging

High-performance low field MRI enables visualization of persistent pulmonary damage after COVID-19 - Heiß, Rafael; Grodzki, David M.; Horger, Wilhelm; Uder, Michael; Nagel, Armin Michael; Bickelhaupt, Sebastian (Magnetic Resonance Imaging, 2021)
The outbreak of coronavirus disease 2019 (COVID-19) with the origin of the spread assumed to be located in Wuhan, China, began in December 2019, and is continuing until now. With the COVID-19 pandemic showing a progressive spread throughout the countries of the world, there is emerging interest for the potential long-term consequences of suffering from a COVID-19 pneumonia. Imaging plays a central role in the diagnosis and management of COVID-19 pneumonia, with chest X-ray examinations and computed tomography (CT) being undoubtedly the modalities most widely used, allowing for a fast and sensitive detection of infiltration patterns associated with COVID-19 pneumonia. For a better understanding of underlying pathomechanisms of pulmonary damage, longitudinal imaging series are warranted, for which CT is of limited usability due to repeated exposure of X-rays. Recent advances in MRI suggested that high-performance low-field MRI might represent a valuable method for pulmonary imaging without the need of radiation exposure. However, so far, low-field MRI has not been applied to study pulmonary damage after COVID-19 pneumonia. We present a case report of a patient who suffered from COVID-19 pneumonia using 0.55 T MRI for follow-up examinations three months after initial infection. Low-field MRI enables a precise visualization of persistent pulmonary changes including ground-glass opacities, which are consistent with CT performed on the same day. Low-field MRI seems to be feasible in the detection of pulmonary involvement in patients with COVID-19 pneumonia and may have the potential for repetitive lung examinations in monitoring the reconvalescence after pulmonary infections.
CRIS-Team Scopus Importer:2020-12-04

High prevalence of tenosynovial inflammation before onset of rheumatoid arthritis and its link to progression to RA-A combined MRI/CT study - Kleyer, Arnd; Krieter, Manuel; Oliveira, Isabelle; Faustini, Francesca; Simon, Dominic; Kämmerer, Nadine; Cavalcante, Alan; Tabosa, Taiane; Rech, Juergen; Hueber, Axel; Schett, Georg (Seminars in Arthritis and Rheumatism, 2016)
To define the anatomic distribution of the earliest inflammatory and structural changes in individuals with anti-citrullinated protein antibody (ACPA+) positivity but no signs of arthritis.ACPA+ individuals (N = 20) and healthy controls (N = 13) received simultaneous gadolinium-enhanced magnetic resonance imaging (MRI) and high-resolution peripheral quantitative computed tomography (HR-pQCT) of the hands. MRI sequences were scored for synovitis, osteitis, and bone erosions according to the RAMRIS method as well as for presence, localization, and extent of tenosynovitis. Bone erosions were validated by HR-pQCT scanning and related to the inflammatory changes found in the MRI.Tenosynovitis was the most prevalent inflammatory pathology, affecting 80% of ACPA+ individuals but none of the controls. Tenosynovitis at two or more anatomical sites was associated with later development of RA. Synovitis (65%) and osteitis (35%) were present in ACPA+ individuals as well, but at a lower frequency than tenosynovitis. MRI bone erosions were found in 65% of the individuals and additionally confirmed by HR-pQCT. Presence of MRI osteitis was the inflammatory pathology most strongly associated with bone erosions.Tenosynovitis is highly prevalent in ACPA+ individuals without arthritis and associated with later development of RA. Small erosions, often linked to osteitis, are also found in ACPA+ individuals without arthritis.
EVALuna2:13297

High-Resolution 3D-constructive interference in steady-state MR imaging and 3D time-of-flight MR angiography in neurovascular compression: A comparison between 3T and 1.5T - Dörfler, Arnd; Garcia, M.; Naraghi, Ramin; Zumbrunn, T.; Roesch, J.; Hastreiter, Peter (American Journal of Neuroradiology, 2012)
BACKGROUND AND PURPOSE: High-resolution MR imaging is useful for diagnosis and preoperative planning in patients with NVC. Because high-field MR imaging promises higher SNR and resolution, the aim of this study was to determine the value of high-resolution 3D-CISS and 3D-TOF MRA at 3T compared with 1.5T in patients with NVC. MATERIALS AND METHODS: Forty-seven patients with NVC, trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia were examined at 1.5T and 3T, including high-resolution 3D-CISS and 3D-TOF MRA sequences. Delineation of anatomic structures, overall image quality, severity of artifacts, visibility of NVC, and assessment of the SNR and CNR were compared between field strengths. RESULTS: SNR and CNR were significantly higher at 3T (P < .001). Significantly better anatomic conspicuity, including delineation of CNs, nerve branches, and assessment of small vessels, was obtained at 3T (P < .02). Severity of artifacts was significantly lower at 3T (P < .001). Consequently, overall image quality was significantly higher at 3T. NVC was significantly better delineated at 3T (P < .001). Six patients in whom NVC was not with certainty identifiable at 1.5T were correctly diagnosed at 3T. CONCLUSIONS: Patients with NVC may benefit from the higher resolution and greater sensitivity of 3T for preoperative assessment of NVC, and 3T may be of particular value when 1.5T is equivocal.
CRIS-Team Scopus Importer:2022-08-05

High-resolution diffusion tensor-imaging indicates asymmetric microstructural disorganization within substantia nigra in early Parkinson's disease - Knossalla, Frauke; Kohl, Zacharias; Winkler, Jürgen; Schwab, Stefan; Schenk, Thomas; Engelhorn, Tobias; Dörfler, Arnd; Gölitz, Philipp (Journal of Clinical Neuroscience, 2018)
BACKGROUND AND PURPOSE: Parkinson's disease (PD) is characterised by neuropathological degenerative changes in the substantia nigra (SN). Our study aimed to evaluate whether high-resolution diffusion tensor-imaging (DTI) can detect anatomical biomarkers in early-stage PD, and has the potential to visualize asymmetry effects comparable to the 123I-FP-CIT SPECT (DaTSCAN). METHODS: Ten early-stage PD patients with mild disease severity and ten age- and gender-matched healthy controls were examined with a high-resolution DTI protocol at a 3 Tesla MRI scanner to assess fractional anisotropy (FA) values in the ventral, middle and dorsal region of SN. In addition, a subgroup of 5 PD patients underwent a DaTSCAN. RESULTS: PD subjects showed reduced FA values in all SN regions compared to controls, but post hoc analysis revealed a significant reduction (p = .032) in the dorsal region. There was no significant correlation between clinical data and FA values. Subgroup analysis of PD patients with asymmetric radioligand uptake in the DaTSCAN demonstrated also significant asymmetric FA values (p = .027) in the dorsal region of SN. CONCLUSIONS: Our results provide preliminary evidence that high-resolution DTI can detect in early-stage PD patients with mild disease severity an anatomical biomarker in the dorsal region of SN, indicating microstructural disorganization. This biomarker, discriminating potentially in vivo between patients and healthy people, could be valuable for early PD diagnosis. If asymmetric radioligand uptake in the DaTSCAN was present, also asymmetry effects in the dorsal region of SN were obtained by DTI. These findings might contribute to improve effectiveness in diagnosing and monitoring PD.
EVALuna2:34272

High-resolution magnetic resonance imaging in isolated, traumatic oculomotor nerve palsy: A case report - Eisenhut, Felix; Gerner, Stefan; Gölitz, Philipp; Dörfler, Arnd; Seifert, Frank (Radiology Case Reports, 2021)
Traumatic, isolated oculomotor nerve palsy is a rare clinical finding and only few reports demonstrate associated magnetic resonance imaging (MRI) findings. Here, we present the case of a 70-year-old woman with left-sided oculomotor nerve palsy following a mild head trauma due to an e-bike accident. Post-traumatic cerebral computed tomography revealed punctiform hemorrhage in the left interpeduncular cistern and the following MRI confirmed an intraneural hemorrhage of the left oculomotor nerve. Nine weeks later, the follow-up MRI showed progressive atrophy and contrast-enhancement of the left oculomotor nerve. To support functional recovery, a treatment with intravenous corticosteroids was started. Six months later, the patient presented with improved oculomotor nerve function and partial recovery of ptosis and diplopia. In accordance, MRI demonstrated recurrent contrast-enhancement of the atrophic nerve. In conclusion, high-resolution MRI allows the reliable delineation of the oculomotor nerve and can support diagnosis in trauma patients with isolated oculomotor nerve palsy.
CRIS-Team Scopus Importer:2020-12-25
Keywords: Case report; Magnetic resonance imaging; Oculomotor nerve; Traumatic nerve palsy

High resolution time-of-flight MR-angiography at 7 T exploiting VERSE saturation, compressed sensing and segmentation - Meixner, Christian; Liebig, Patrick; Speier, Peter; Forman, Christoph; Hensel, Bernhard; Schmidt, Manuel; Saake, Marc; Uder, Michael; Dörfler, Arnd; Heidemann, Robin M.; Schmitter, Sebastian; Nagel, Armin Michael (Magnetic Resonance Imaging, 2019)
Background: 3D Time-of-Flight (TOF) MR-angiography (MRA) substantially benefits from ultra-high magnetic field strengths (≥7 T) due to increased Signal-to-Noise ratio and improved contrast. However, high-resolution TOF-MRA usually requires long acquisition times. In addition, specific absorption rate constraints limit the choice of optimal pulse sequence parameters, especially if venous saturation is employed. Purpose: To implement and evaluate an arterial TOF-MRA for accelerated high-resolution angiography at ultra-high magnetic field strength. Field strengths/sequence: 7 T modified gradient-echo TOF sequence including venous saturation using Variable-Rate Selective Excitation (VERSE), Compressed Sensing (CS) and sparse application of saturation pulses, called segmentation, were included for acceleration. Assessment: To analyze the acceleration techniques all volunteers were examined with the same protocols. CS with different sampling patterns and regularization factors as well as segmentation were applied for acceleration. For comparison, conventional acceleration techniques were applied (GRAPPA PAT 3 and Partial Fourier (6/8 in slice/phase encoding)). Images were co-registered and 40 mm thick transversal maximum intensity projections were created to calculate the relative number of vessels. To analyze the visibility of small vessels, the lenticulostriate arteries (LSA) were examined. This was done via multiscale vessel enhancement filtering in a VOI and quantification via Fiji ImageJ as well as qualitatively evaluation by two radiologists. Additionally, the venous/arterial vessel-to-background ratios (vVBR/aVBR) were calculated for chosen protocols. Results: For the acceleration of a high resolution TOF-MRA (0.31 mm isotropic), under-sampling of 9.6 showed aliasing artifacts, whereas 7.2 showed no aliasing. The regularization factor R had a strong impact on the image quality according to smoothing (R = 0.01 to R = 0.005) and noise (R = 0.0005 to R = 0.00005). With the alternating sampling patterns it was shown that the k-space center should not be under-sampled too much. Additionally segmentation could be verified to be feasible for stronger acceleration with sufficient venous suppression. Conclusion: The combination of several independent techniques (VERSE, CS with acceleration factor 7.2, R = 0.001, Poisson disc radius of 80%, 3 segments) enables the application of high-resolution (0.31 mm isotropic) TOF-MRA with venous saturation at 7 T in clinical time settings (TA ≈ 5 min) and within the SAR limits.
CRIS-Team Scopus Importer:2019-08-30
Keywords: 7 Tesla; Compressed sensing; MR-angiography; Time-of-flight; Ultra-high field; VERSE

High-speed flat-detector computed tomography for temporal bone imaging and postoperative control of cochlear implants - Eisenhut, Felix; Manhart, Michael; Thimsen, Vivian; Mantsopoulos, Konstantinos; Iro, Heinrich; Hornung, Joachim; Dörfler, Arnd; Lang, Stefan; Taha, Lava (Neuroradiology, 2022)
Purpose: Flat-detector computed tomography (FD-CT) is the standard for cochlear implant (CI) imaging. FD-CT systems differ in technical characteristics. Our aim was an evaluation of two different FD-CT generations with different protocols and hardware regarding image quality, radiation dose, and scan time. Methods: Two temporal bone specimens (− / + CI = TB0/TB1) were scanned using three different scanners: two FD-CT systems with different scanning protocols (standard FD-CT: 20 s 70 kV, 20 s 109 kV; high-speed FD-CT [HS-FD-CT]: 7 s 109 kV, 9 s 109 kV, 14 s 72 kV) and MS-CT (5 s 120 kV). Acquired datasets were evaluated in consensus reading regarding qualitative and quantitative parameters: addressing CI- and cochlea-specific parameters, cochlea delineation, lamina spiralis ossea visibility, distinction of single CI electrodes, determination of intracochlear implant position, stapes delineation, and mastoidal septation were assessed. Addressing protocol-specific parameters, radiation dose (dose-length-product/DLP), and scan time were assessed. Results: Two HS-FD-CT protocols (14 s/9 s) provide higher or equivalent diagnostic information regarding CI- and cochlea-specific parameters compared to both standard FD-CT protocols. The fastest HS-FD-CT protocol (7 s)—providing inferior diagnostic information compared to all other FD-CT protocols—still exceeds MS-CT. The highest DLP was recorded for the 14 s HS-FD-CT protocol (TB1 = 956 mGycm); the lowest DLPs were recorded for the 7 s HS-FD-CT protocol (TB0 = 188 mGycm) and for MS-CT (TB0 = 138 mGycm), respectively. HS-FD-CT allows a significant reduction of scan time compared to standard FD-CT. Conclusion: High-speed FD-CT improves visualization of temporal bone anatomy and postoperative assessment of CIs by combining excellent image quality, fast scan time, and reasonable radiation exposure.
CRIS-Team Scopus Importer:2022-04-22
Keywords: Anatomy; Cochlear implant; Flat-detector computed tomography; Postoperative control; Temporal bone

High versus moderate intense running exercise - effects on cardiometabolic risk-factors in untrained males - Kemmler, Wolfgang; Lell, Michael; Scharf, M.; Fraunberger, Leonard; von Stengel, Simon (Deutsche Medizinische Wochenschrift, 2015)
Introduction | The philosophy on how to improve cardiometabolic risk factors most efficiently by endurance exercise is still controversial. To determine the effect of high-intensity (interval) training (HI[I]T) vs. moderate-intensity continuous exercise (MICE) training on cardiometabolic risk factors we conducted a 16-week crossover randomized controlled trial. Methods | 81 healthy untrained middle aged men were randomly assigned to a HI(I)T-group and a control-group that started the MICE running program after their control status. HI(I)T consisted of running exercise around or above the individual anaerobic threshold (? 80- 100 % HRmax); MICE focused on continuous running exercise at ? 65-77.5 % HRmax. Both protocols were comparable with respect to energy consumption. Study endpoints were cardiorespiratory fitness (VO2max), left ventricular mass index (LVMI), metabolic syndrome Z-score (MetS-Z-score), intima-media-thickness (IMT) and body composition. Results | VO2max-changes in this overweighed male cohort significantly (p=0.002) differ between HIIT (14.7 ± 9.3 %, p=0.001) and MICE (7.9 ± 7.4 %,p=0.001). LVMI, as determined via magnetic resonance imaging, significantly increased in both exercise groups (HIIT: 8.5 ± 5.4 %, p=0.001 vs. MICE: 5.3 ± 4.0 %, p=0.001), however the change was significantly more pronounced (p=0.005) in the HIIT-group. MetS-Z-score (HIIT: -2.06 ± 1.31, p=0.001 vs. MICE: -1.60 ± 1.77, p=0.001) and IMT (4.6 ± 5.9 % p=0.011 vs. 4.4 ± 8.1 %, p=0.019) did not show significant group-differences. Reductions of fat mass (-4.9 ± 9.0 %, p=0.010 vs. -9.5 ± 9.4, p=0.001) were significantly higher among the MICE-participants (p=0.034), however, the same was true (p=0.008) for lean body mass (0.5 ± 2.3 %, p=0.381 vs. -1.3 ± 2.0 %, p=0.003). Conclusion | In summary high-intensity interval training tends to impact cardiometabolic health more favorable compared with a moderate-intensity continuous endurance exercise protocol.
EVALuna2:10109

Histopathological proof of the pathogenicity of a rare GFAP mutation in a patient with flaccid paraparesis - Brackmann, Florian; Coras, Roland; Rössler, Karl; Kraus, Cornelia; Rompel, Oliver; Trollmann, Regina (Brain & Development, 2017)
Infantile Alexander disease is a rare progressive leukodystrophy caused by autosomal dominant mutations in the (GFAP) gene typically presenting with psychomotor retardation, progressive macrocephaly and refractory epilepsy. Neuroradiological hallmarks are extensive white matter lesions with frontal preponderance as well as signal intensity changes of basal ganglia and medulla oblongata with variable contrast enhancement. Here, we report an atypical manifestation in a 21-month-old boy presenting with flaccid paraparesis and areflexia. Cognitive, visual as well as fine motor skills and muscular strength of the upper extremities were appropriate for age. Weight and height as well as head circumference were within normal range. Clinical or electroencephalographic signs of seizures were absent. Cranial MRI demonstrated bifrontal cystic tumorous lesions with partial contrast rims, as well as space-occupying focal lesions of the caudate nuclei. Spinal MRI revealed swelling of the lumbar and cervical spinal cord. CSF and blood chemistry showed normal results. Histopathology of a subcortical lesion showed large amounts of Rosenthal fibers and protein droplets characteristic of Alexander disease. Sequencing detected a heterozygous mutation of the GFAP gene (c.205G > A; p.(Glu69Lys)) that has been reported before as probably pathogenetic in another case of lower spinal involvement. This well documented case draws attention to atypical spinal manifestations of Alexander disease and gives histopathological proof of the pathogenetic role of a rare GFAP mutation with marked spinal involvement.
EVALuna2:9396

HLA-DO: a possible switch between GvHD and GvL effect - Zeun, J.; Neubeck, S.; Lang, Vanessa; Flamann, Cindy; Nagel, L.; Kunert, Timo; Vogler, T.; Brey, Stefanie; Hildner, Kai; Bäuerle, Tobias; Büttner-Herold, Maike; Winkler, Thomas; et al. (EUROPEAN JOURNAL OF IMMUNOLOGY, 2022)
CRIS-Team WoS Importer:2023-01-27

How COVID-19 kick-started online learning in medical education-The DigiMed study - Stoehr, Fabian; Müller, Lukas; Brady, Adrian; Trilla, Antoni; Mähringer-Kunz, Aline; Hahn, Felix; Düber, Christoph; Becker, Nicole; Wörns, Marcus Alexander; Chapiro, Julius; Hinrichs, Jan Bernd; Akata, Deniz; et al. (PLoS ONE, 2021)
Background The coronavirus disease 2019 (COVID-19) pandemic led to far-reaching restrictions of social and professional life, affecting societies all over the world. To contain the virus, medical schools had to restructure their curriculum by switching to online learning. However, only few medical schools had implemented such novel learning concepts. We aimed to evaluate students' attitudes to online learning to provide a broad scientific basis to guide future development of medical education. Methods Overall, 3286 medical students from 12 different countries participated in this cross-sectional, web-based study investigating various aspects of online learning in medical education. On a 7-point Likert scale, participants rated the online learning situation during the pandemic at their medical schools, technical and social aspects, and the current and future role of online learning in medical education. Results The majority of medical schools managed the rapid switch to online learning (78%) and most students were satisfied with the quantity (67%) and quality (62%) of the courses. Online learning provided greater flexibility (84%) and led to unchanged or even higher attendance of courses (70%). Possible downsides included motivational problems (42%), insufficient possibilities for interaction with fellow students (67%) and thus the risk of social isolation (64%). The vast majority felt comfortable using the software solutions (80%). Most were convinced that medical education lags behind current capabilities regarding online learning (78%) and estimated the proportion of online learning before the pandemic at only 14%. In order to improve the current curriculum, they wish for a more balanced ratio with at least 40% of online teaching compared to on-site teaching. Conclusion This study demonstrates the positive attitude of medical students towards online learning. Furthermore, it reveals a considerable discrepancy between what students demand and what the curriculum offers. Thus, the COVID-19 pandemic might be the long-awaited catalyst for a new "online era"in medical education.
CRIS-Team Scopus Importer:2021-10-22

How to effectively utilize imaging in disease-modifying treatments for osteoarthritis clinical trials: the radiologist's perspective - Hayashi, Daichi; Roemer, Frank; Guermazi, Ali (Expert Review of Molecular Diagnostics, 2021)
Introduction: One of the reasons for failures of disease-modifying osteoarthritis drug clinical trials has been the radiography-based definition of structural eligibility criteria. Imaging, particularly MRI, has a critical role in planning and conducting clinical trials of osteoarthritis. Areas covered: A literature search was performed using keywords including 'osteoarthritis,' 'knee,' 'MRI,' 'intra-articular injection,' 'semiquantitative scoring,' 'clinical trial,' and other specific terms where relevant. The core concepts of using MRI in osteoarthritis clinical trials are explained focusing on knee osteoarthritis, including its role in determining patient eligibility and inclusion/exclusion criteria as well as outcome measures from the expert musculoskeletal radiologist's perspective. A brief overview of statistical analyses that should be deployed in clinical trials utilizing semiquantitative MRI analyses is discussed. Expert opinion: In order to increase chances to detect measurable efficacy effects, investigators should consider utilizing MRI from screening to outcome assessment. Recognition of several phenotypes of osteoarthritis helps in participant stratification and will lead to more targeted clinical trials. Inclusion and exclusion criteria need to be defined using not only radiography but also MRI. Correct intra-articular injection of investigational compounds is critically important if intra-articular drug delivery is required, and such procedure should be performed and documented using appropriate imaging guidance.
CRIS-Team WoS Importer:2021-06-11

How to use the Kaiser score as a clinical decision rule for diagnosis in multiparametric breast MRI: a pictorial essay - Dietzel, Matthias; Baltzer, Pascal A. T. (Insights into Imaging, 2018)
Due to its superior sensitivity, breast MRI (bMRI) has been established as an important additional diagnostic tool in the breast clinic and is used for screening in patients with an elevated risk for breast cancer. Breast MRI, however, is a complex tool, providing multiple images containing several contrasts. Thus, reading bMRI requires a structured approach. A lack of structure will increase the rate of false-positive findings and sacrifice most of the advantages of bMRI as additional work-up will be required. While the BI-RADS (Breast Imaging Reporting And Data System) lexicon is a major step toward standardised and structured reporting, it does not provide a clinical decision rule with which to guide diagnostic decisions. Such a clinical decision rule, however, is provided by the Kaiser score, which combines five independent diagnostic BI-RADS lexicon criteria (margins, SI-time curve type, internal enhancement and presence of oedema) in an intuitive flowchart. The resulting score provides probabilities of malignancy that can be used for evidence-based decision-making in the breast clinic. Notably, considerable benefits have been demonstrated for radiologists with initial and intermediate experience in bMRI. This pictorial essay is a practical guide to the application of the Kaiser score in the interpretation of breast MRI examinations. TEACHING POINTS: • bMRI requires standardisation of patient-management, protocols, and reading set-up. • Reading bMRI includes the assessment of breast parenchyma, associated findings, and lesions. • Diagnostic decisions should be made according to evidence-based clinical decision rules. • The evidence-based Kaiser score is applicable independent of bMRI protocol and scanner. • The Kaiser score provides high diagnostic accuracy with low inter-observer variability.
EVALuna2:212711

Hybrid B1+-shimming and gradient adaptions for improved pseudo-continuous arterial spin labeling at 7 Tesla - Meixner, Christian; Eisen, Christian; Schmitter, Sebastian; Müller, Max; Herrler, Jürgen; Hensel, Bernhard; Dörfler, Arnd; Uder, Michael; Nagel, Armin Michael (Magnetic Resonance in Medicine, 2021)
Purpose: To improve pseudo-continuous arterial spin labeling (pcASL) at 7T by exploiting a hybrid homogeneity- and efficiency-optimized (Formula presented.) -shim with adapted gradient strength as well as background suppression. Methods: The following three experiments were performed at 7T, each employing five volunteers: (1) A hybrid (ie, homogeneity-efficiency optimized) (Formula presented.) -shim was introduced and evaluated for variable-rate selective excitation pcASL labeling. Therefore, (Formula presented.) -maps in the V3 segment and time-of-flight images were acquired to identify the feeding arteries. For validation, a gradient-echo sequence was applied in circular polarized (CP) mode and with the hybrid (Formula presented.) -shim. Additionally, the gray matter (temporal) signal-to-noise ratio (tSNR) in pcASL perfusion images was evaluated. (2) Bloch simulations for the pcASL labeling were conducted and validated experimentally, with a focus on the slice-selective gradients. (3) Background suppression was added to the (Formula presented.) -shimmed, gradient-adapted 7T sequence and this was then compared to a matched sequence at 3T. Results: The (Formula presented.) -shim improved the signal within the labeling plane (23.6%) and the SNR/tSNR increased (+11%/+11%) compared to its value in CP mode; however, the increase was not significant. In accordance with the simulations, the adapted gradients increased the tSNR (35%) and SNR (45%) significantly. Background suppression further improved the perfusion images at 7T, and this protocol performed as well as a resolution-matched protocol at 3T. Conclusion: The combination of the proposed hybrid (Formula presented.) -phase-shim with the adapted slice-selective gradients and background suppression shows great potential for improved pcASL labeling under suboptimal (Formula presented.) conditions at 7T.
CRIS-Team Scopus Importer:2021-08-27
Keywords: 7 Tesla; B1 shimming; pcASL; pTx; ultra-high field strengths; VERSE

Hybrid Imaging (PET-Computed Tomography/PET-MR Imaging) of Bone Metastases - Schmidkonz, Christian; Ellmann, Stephan; Ritt, Philipp; Roemer, Frank; Guermazi, Ali; Uder, Michael; Kuwert, Torsten; Bäuerle, Tobias (PET Clinics, 2019)
Bone metastases are a common source of osseous malignancy in the skeleton and affect up to 70% of all cancer patients. Hybrid imaging modalities including positron emission tomography (PET)/computed tomography (CT) and PET/MRI play an increasing role for the detection and follow-up of metastatic disease, especially in monitoring treatment response upon local or systemic therapy. This review summarizes current applications of PET/CT and PET/MRI in the clinical setting for imaging of metastases.
CRIS-Team WoS Importer:2020-02-21

Hybrid ultrasound and single wavelength optoacoustic imaging reveals muscle degeneration in peripheral artery disease - Träger, Anna P.; Günther, Josefine; Raming, Roman; Paulus, Lars-Philip; Lang, Werner; Meyer, Alexander; Kempf, Julius; Caranovic, Milenko; Li, Yi; Wagner, Alexandra; Tan, Lina; Danko, Vera; et al. (Photoacoustics, 2024)
Peripheral arterial disease (PAD) leads to chronic vascular occlusion and results in end organ damage in critically perfused limbs. There are currently no clinical methods available to determine the muscular damage induced by chronic mal-perfusion. This monocentric prospective cross-sectional study investigated n = 193 adults, healthy to severe PAD, in order to quantify the degree of calf muscle degeneration caused by PAD using a non-invasive hybrid ultrasound and single wavelength optoacoustic imaging (US/SWL-OAI) approach. While US provides morphologic information, SWL-OAI visualizes the absorption of pulsed laser light and the resulting sound waves from molecules undergoing thermoelastic expansion. US/SWL-OAI was compared to multispectral data, clinical disease severity, angiographic findings, phantom experiments, and histological examinations from calf muscle biopsies. We were able to show that synergistic use of US/SWL-OAI is most likely to map clinical degeneration of the muscle and progressive PAD.
CRIS-Team Scopus Importer:2023-12-15
Keywords: Muscle degeneration; Muscle imaging; Optoacoustics; Peripheral artery disease; Photoacoustics

Hypertension urgencies in the SPYRAL HTN-OFF MED Pivotal trial - Weber, Michael A.; Schmieder, Roland; Kandzari, David E.; Townsend, Raymond R.; Mahfoud, Felix; Tsioufis, Konstantinos; Kario, Kazuomi; Pocock, Stuart; Tatakis, Fotis; Ewen, Sebastian; Choi, James W.; East, Cara; et al. (Clinical Research in Cardiology, 2022)
The SPYRAL HTN-OFF MED Pivotal trial (https://clinicaltrials.gov/ct2/show/NCT02439749) demonstrated significant reductions in blood pressure (BP) after renal denervation (RDN) compared to sham control in the absence of anti-hypertensive medications. Prior to the 3-month primary endpoint, medications were immediately reinstated for patients who met escape criteria defined as office systolic BP (SBP) >= 180 mmHg or other safety concerns. Our objective was to compare the rate of hypertensive urgencies in RDN vs. sham control patients. Patients were enrolled with office SBP >= 150 and < 180 mmHg, office diastolic BP (DBP) >= 90 mmHg and mean 24 h SBP >= 140 and < 170 mmHg. Patients had been required to discontinue any anti-hypertensive medications and were randomized 1:1 to RDN or sham control. In this post-hoc analysis, cumulative incidence curves with Kaplan-Meier estimates of rate of patients meeting escape criteria were generated for RDN and sham control patients. There were 16 RDN (9.6%) and 28 sham control patients (17.0%) who met escape criteria between baseline and 3 months. There was a significantly higher rate of sham control patients meeting escape criteria compared to RDN for all escape patients (p = 0.032), as well as for patients with a hypertensive urgency with office SBP >= 180 mmHg (p = 0.046). Rate of escape was similar between RDN and sham control for patients without a measured BP exceeding 180 mmHg (p = 0.32). In the SPYRAL HTN-OFF MED Pivotal trial, RDN patients were less likely to experience hypertensive urgencies that required immediate use of anti-hypertensive medications compared to sham control.
CRIS-Team WoS Importer:2022-07-29

Hyponatremia is an independent predictor of in-hospital mortality in spontaneous intracerebral hemorrhage - Kuramatsu, Joji; Bobinger, Tobias; Volbers, Bastian; Staykov, Dimitre; Lücking, Hannes; Kloska, Stephan; Köhrmann, Martin; Huttner, Hagen (Stroke, 2014)
Hyponatremia is the most frequent electrolyte disturbance in critical care. Across various disciplines, hyponatremia is associated with increased mortality and longer hospital stay, yet in intracerebral hemorrhage (ICH) no data are available. This the first study that investigated the prevalence and clinical associations of hyponatremia in patients with ICH.This observational study included all consecutive spontaneous ICH patients (n=464) admitted during a 5-year period to the Department of Neurology. Patient characteristics, in-hospital measures, mortality, and functional outcome (90 days and 1 year) were analyzed to determine the effects of hyponatremia (Na<135 mEq/L). Multivariable regression analyses were calculated for factors associated with hyponatremia and predictors of in-hospital mortality.The prevalence of hyponatremia on hospital admission was 15.6% (n=66). Normonatremia was achieved and maintained in almost all hyponatremia patients<48 hours. In-hospital mortality was roughly doubled in hyponatremia compared with nonhyponatremia patients (40.9%; n=27 versus 21.1%; n=75), translating into a 2.5-fold increased odds ratio (P<0.001). Multivariable analyses identified hyponatremia as an independent predictor of in-hospital mortality (odds ratio, 2.2; 95% confidence interval, 1.05-4.62; P=0.037). Within 90 days after ICH, hyponatremia patients surviving hospital stay were also at greater risk of death (odds ratio, 4.8; 95% confidence interval, 2.1-10.6; P<0.001); thereafter, mortality rates were similar.Hyponatremia was identified as an independent predictor of in-hospital mortality with a fairly high prevalence in spontaneous ICH patients. The presence of hyponatremia at hospital admission is related to an increased short-term mortality in patients surviving acute care, possibly reflecting a preexisting condition that is linked to worse outcome due to greater comorbidity. Correction of hyponatremia does not seem to compensate its influence on mortality, which strongly warrants future research.
EVALuna2:22304

Hypoxia and microvascular alterations are early predictors of IDH-mutated anaplastic glioma recurrence - Stadlbauer, Andreas; Oberndorfer, Stefan; Heinz, Gertraud; Zimmermann, Max; Kinfe, Thomas Mehari; Dörfler, Arnd; Buchfelder, Michael; Kremenevski, Natalia; Marhold, Franz (Cancers, 2021)
Anaplastic gliomas (AG) represents aggressive brain tumors that often affect young adults. Although isocitrate-dehydrogenase (IDH) gene mutation has been identified as a more favorable prognostic factor, most IDH-mutated AG patients are confronted with tumor recurrence. Hence, increased knowledge about pathophysiological precursors of AG recurrence is urgently needed in order to develop precise diagnostic monitoring and tailored therapeutic approaches. In this study, 142 physiological magnetic resonance imaging (phyMRI) follow-up examinations in 60 AG patients after standard therapy were evaluated and magnetic resonance imaging (MRI) biomarker maps for microvascular architecture and perfusion, neovascularization activity, oxygen metabolism, and hypoxia calculated. From these 60 patients, 34 patients developed recurrence of the AG, and 26 patients showed no signs for AG recurrence during the study period. The time courses of MRI biomarker changes were analyzed regarding early pathophysiological alterations over a one-year period before radiological AG recurrence or a one-year period of stable disease for patients without recurrence, respectively. We detected intensifying local tissue hypoxia 250 days prior to radiological recurrence which initiated upregulation of neovascularization activity 50 to 70 days later. These changes were associated with a switch from an avascular infiltrative to a vascularized proliferative phenotype of the tumor cells another 30 days later. The dynamic changes of blood perfusion, microvessel density, neovascularization activity, and oxygen metabolism showed a close physiological interplay in the one-year period prior to radiological recurrence of IDH-mutated AG. These findings may path the wave for implementing both new MR-based imaging modalities for routine follow-up monitoring of AG patients after standard therapy and furthermore may support the development of novel, tailored therapy options in recurrent AG.
CRIS-Team Scopus Importer:2021-04-16
Keywords: Anaplastic glioma; Hypoxia; IDH gene mutation; Isocitrate-dehydrogenase; Neovascularization; Physiological MRI; Recurrence; Treatment failure; Vascular cooption

Identification of anatomic risk factors for scalar translocation in cochlear implant patients - Eisenhut, Felix; Lang, Stefan; Hölter, Philip; Wiesmüller, Marco; Uder, Michael; Iro, Heinrich; Dörfler, Arnd; Hornung, Joachim; Taha, Lava (Zeitschrift für Medizinische Physik, 2021)
Aim: Microanatomical evaluation of cochlear implant (CI) patients to identify anatomical risk factors for a scalar translocation. Methods: CI patients with both a regular scala tympani spiralization (group A) and a scalar translocation (group B) were identified via postoperative flat-detector computed tomography (FD-CT). Then, the corresponding preoperative multislice computed tomography (MS-CT) and postoperative FD-CT datasets were assessed: First, the cochleae were separated in 6 segments of 45° each. Next, quantitative (cochlea height, length, depth, cochlear duct diameter [CD] per segment; percentual tapering of the CD per segment named cochlear geometry index [CGI]) and qualitative (identifiability of the CI model; CI-integrity; intracochlear array position) parameters were evaluated and compared for both groups. Receiver-operating-characteristics (ROC) analysis was performed for the CGI. Results: In total, 40 preoperative MS-CT and postoperative FD-CT datasets (nA = 20; nB = 20) were analysed. Model “CI 512” was successfully identified and CI-integrity has been confirmed in all cases. Quantitative analysis showed a significant difference of both the CD at 0° (CDA 0°= 2.06 ± 0.23 mm; CDB 0°= 2.19 ± 0.18 mm; p0°= 0.04) and the CGI of the first segment (CGIA 0° -45°= 18.87 ± 6.04%; CGIB 0°-45°= 28.89 ± 8.58%; p0°-45°= 0.0001). For all other 5 cochlear segments there was no significant difference of CD and CGI; there was no significant difference of external cochlea diameters. The area under the curve (AUC) of the CGI0-45° was 0.864 with 24.50° as the optimal cut-off value to discriminate patients with a scala tympani spiralization and a scalar translocation. CGI0-45° of > 24.50° allowed the correct identification of 85% of patients with a scalar translocation. Conclusion: CI insertion trauma is associated with a significantly higher narrowing of the proximal basal cochlea turn (BCT). The CGI as percentual tapering of the BCT turned out as reliable, clinically applicable parameter for identification of patients with an increased risk for a scalar translocation.
CRIS-Team Scopus Importer:2021-03-12
Keywords: anatomical parameters; Cochlear implant; flat-detector computed tomography; insertion trauma; scalar translocation

Identification of circulating microRNA patterns in patients in psoriasis and psoriatic arthritis - Haschka, Judith; Simon, David; Bayat, Sara; Messner, Zora; Kampylafka, Eleni; Fagni, Filippo; Skalicky, Susanna; Hackl, Matthias; Resch, Heinrich; Zwerina, Jochen; Kleyer, Arnd; Cavallaro, Alexander Josef; et al. (Rheumatology, 2023)
Objective miRNAs are small non-coding RNAs that control gene expression. Specific intra- and extracellular miRNA signatures have been identified in various diseases. Whether certain miRNA signatures are associated with psoriasis (PsO) and PsA is currently unknown. We aimed to search for circulating miRNA signatures associated with PsO and PsA patients. Methods Expression of miRNAs was analysed by reverse transcription quantitative real-time PCR (RT-qPCR) in the serum of PsA, PsO patients and healthy controls. Demographic and disease-specific characteristics and imaging data from hand MRI were recorded. In the discovery phase, 192 miRNA assays were analysed in 48 samples (PsA, PsO, controls: each N = 16). For validation, 17 selected miRNAs were measured in the total population. Results A total of 141 patients and controls were analysed (51 PsA, 40 PsO, 50 controls). In the discovery phase 51 miRNAs in PsO and 64 miRNAs in PsA were down- or upregulated compared with controls, with 33 miRNAs being changed in both (adj. P < 0.05). The 17 top candidates from discovery were assessed in the validation phase, 9 of them discriminated PsA and PsO from controls [area under the curve (AUC) >= 0.70, all P < 0.05]. Four miRNAs (miR-19b-3p, miR-21-5p, miR-92a-3p and let-7b-5p) were significantly differently regulated between PsO and PsA. A combination of these miRNAs increased the AUC to 0.92 in multivariate regression model to discriminate PsO and PsA. Conclusion miRNA signatures in PsA and PsO patients differ from controls. Nine miRNAs were differentially regulated in PsA and PsO patients, five of them previously reported to be involved in bone and cartilage metabolism, indicating an intimate association of psoriatic inflammation and bone/cartilage changes.
CRIS-Team WoS Importer:2023-03-17

Identification of impactful imaging biomarker: Clinical applications for breast and prostate carcinoma - Bäuerle, Tobias; Dietzel, Matthias; Pinker, Katja; Bonekamp, David; Zhang, Kevin S.; Schlemmer, Heinz Peter; Bannas, Peter; Cyran, Clemens C.; Eisenblätter, Michel; Hilger, Ingrid; Jung, Caroline; Schick, Fritz; et al. (Röfo: Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2023)
Background Imaging biomarkers are quantitative parameters from imaging modalities, which are collected noninvasively, allow conclusions about physiological and pathophysiological processes, and may consist of single (monoparametric) or multiple parameters (bi- or multiparametric). Method This review aims to present the state of the art for the quantification of multimodal and multiparametric imaging biomarkers. Here, the use of biomarkers using artificial intelligence will be addressed and the clinical application of imaging biomarkers in breast and prostate cancers will be explained. For the preparation of the review article, an extensive literature search was performed based on Pubmed, Web of Science and Google Scholar. The results were evaluated and discussed for consistency and generality. Results and Conclusion Different imaging biomarkers (multiparametric) are quantified based on the use of complementary imaging modalities (multimodal) from radiology, nuclear medicine, or hybrid imaging. From these techniques, parameters are determined at the morphological (e.g., size), functional (e.g., vascularization or diffusion), metabolic (e.g., glucose metabolism), or molecular (e.g., expression of prostate specific membrane antigen, PSMA) level. The integration and weighting of imaging biomarkers are increasingly being performed with artificial intelligence, using machine learning algorithms. In this way, the clinical application of imaging biomarkers is increasing, as illustrated by the diagnosis of breast and prostate cancers. Key Points: Imaging biomarkers are quantitative parameters to detect physiological and pathophysiological processes. Imaging biomarkers from multimodality and multiparametric imaging are integrated using artificial intelligence algorithms. Quantitative imaging parameters are a fundamental component of diagnostics for all tumor entities, such as for mammary and prostate carcinomas. Citation Format Bäuerle T, Dietzel M, Pinker K etal. Identification of impactful imaging biomarker: Clinical applications for breast and prostate carcinoma. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2175-4446.
CRIS-Team Scopus Importer:2023-12-01
Keywords: artificial intelligence; biomarker; breast cancer; imaging; prostate cancer; quantification

IgG4-related fasciitis - Morf, Harriet; Roemer, Frank; Agaimy, Abbas; Schett, Georg; Manger, Bernhard (Rheumatology, 2022)
CRIS-Team WoS Importer:2022-02-18

Image guiding techniques and navigation for TACE, SIRT and TIPS Bildführungstechniken und Navigation bei TACE, SIRT und TIPS - Adamus, R.; Pfister, Marcus; Uder, Michael; Loose, R. W. (Radiologe, 2013)
Clinical/methodical issue: To avoid non-targeted embolization in liver tumors, arteries important for embolization must be detected. In transarterial chemoembolization (TACE) arteries for particle embolization have to be detected and in selective internal radiotherapy (SIRT) extrahepatic arteries which must be protected from embolization have to be detected. In transjugular intrahepatic portosystemic shunt (TIPS) the problem is to achieve an exactly targeted puncture of the portal vein. Standard radiological methods: In TACE and SIRT detection of the vessels is performed from various angles by digital subtraction angiography (DSA). In TIPS puncture is guided by ultrasound or performed blindly. Methodical innovations: Using cone beam CT (CBCT) very small vessels in the liver can be visualized and 2D-3D back projection is able to detect the exact position of the portal vein in TIPS. Achievements: The use of CBCT and 2D-3D back projection significantly enhances navigation of vessels. Practical recommendations: If flat detector technique is available CBCT should be used in TACE and SIRT and 2D-3D navigation needs hardware and software updates. © 2013 Springer-Verlag Berlin Heidelberg.
CRIS-Team Scopus Importer:2023-03-08
Keywords: Cone beam computed tomography (CBCT); Digital subtraction angiography (DSA); Embolization; Navigation; Puncture

Image Quality and Detection of Small Focal Liver Lesions in Diffusion-Weighted Imaging Comparison of Navigator Tracking and Free-Breathing Acquisition - Saake, Marc; Seuß, Hannes; Riexinger, Andreas; Bickelhaupt, Sebastian; Hammon, Matthias; Uder, Michael; Laun, Frederik Bernd (Investigative Radiology, 2021)
Objectives The aim of this study was to compare intraindividual diffusion-weighted imaging (DWI) of the liver acquired with free breathing (FB) versus navigator triggering (NT) for assessing small focal liver lesions (FLLs) in noncirrhotic patients. Materials and Methods Patients with known or suspected multiple FLLs were prospectively included, and spin-echo echo-planar DWI with NT and FB acquisition was performed (b-values, 50 and 800 s/mm(2) [b50 and b800]). NT and FB DWI sequences with similar acquisitions times were used. Liver and lesion signal-to-noise ratios were measured at b800. The DWI scans were analyzed independently by 2 readers. Liver edge delineation, presence of stair-step artifacts, vessel sharpness, severity of cardiac motion artifacts, overall image quality, and lesion conspicuity were rated with 5-point Likert scales. Small and large FLLs (ie, <1 cm or >= 1 cm) were rated separately for lesion conspicuity. The FLL detectability was estimated by comparing the number of lesions visible with FB to those visible with NT. Results Forty-three patients were included in the study. The FB acquisition performed better in terms of severity of cardiac motion artifacts. The NT performed better in terms of liver edge delineation and vessel sharpness. Little difference was found for stair-step artifact, overall image quality, and conspicuity of large FLL, whereas the conspicuity of small FLL was better for NT. For small FLL, both readers found more lesions with NT in 11 cases at b800. For large FLL, this effect was much less pronounced (1 case at b800 reported by 1 of the readers). The mean liver and lesion signal-to-noise ratios were 16.8/41.5 and 19.8/38.4 for NT/FB, respectively. Conclusions Small FLL detection is better with NT. Large FLL detection by FB and NT is similarly good. We conclude that NT should be used.
CRIS-Team WoS Importer:2021-09-03

Image quality assessment using deep learning in high b-value diffusion-weighted breast MRI. - Kapsner, Lorenz; Balbach, Eva; Folle, Lukas; Laun, Frederik Bernd; Nagel, Armin Michael; Liebert, Andrzej; Emons, Julius; Ohlmeyer, Sabine; Uder, Michael; Wenkel, Evelyn; Bickelhaupt, Sebastian (Scientific Reports, 2023)
The objective of this IRB approved retrospective study was to apply deep learning to identify magnetic resonance imaging (MRI) artifacts on maximum intensity projections (MIP) of the breast, which were derived from diffusion weighted imaging (DWI) protocols. The dataset consisted of 1309 clinically indicated breast MRI examinations of 1158 individuals (median age [IQR]: 50 years [16.75 years]) acquired between March 2017 and June 2020, in which a DWI sequence with a high b-value equal to 1500 s/mm2 was acquired. From these, 2D MIP images were computed and the left and right breast were cropped out as regions of interest (ROI). The presence of MRI image artifacts on the ROIs was rated by three independent observers. Artifact prevalence in the dataset was 37% (961 out of 2618 images). A DenseNet was trained with a fivefold cross-validation to identify artifacts on these images. In an independent holdout test dataset (n = 350 images) artifacts were detected by the neural network with an area under the precision-recall curve of 0.921 and a positive predictive value of 0.981. Our results show that a deep learning algorithm is capable to identify MRI artifacts in breast DWI-derived MIPs, which could help to improve quality assurance approaches for DWI sequences of breast examinations in the future.
EVALuna2:539553

Image quality comparison of single-energy and dual-energy computed tomography for head and neck patients: a prospective randomized study - Bedernik, Andreas; Wüst, Wolfgang; May, Matthias; Heiß, Rafael; Uder, Michael; Wiesmüller, Marco (European Radiology, 2022)
Objectives: The aim of this study was to compare the quality of images obtained using single-energy computed tomography (SECT) performed with automated tube voltage adaptation (TVA) with dual-energy CT (DECT) weighted average images. Methods: Eighty patients were prospectively randomized to undergo either SECT with TVA (n = 40, ref. mAs 200) or radiation dose–matched DECT (n = 40, 80/Sn150 kV, ref. mAs tube A 91/tube B 61) on a dual-source CT scanner. Objective image quality was evaluated as dose-normalized contrast-to-noise ratio (CNRD) for the jugular veins relative to fatty tissue and muscle tissue and for muscle tissue relative to fatty issue. For subjective image quality, reproduction of anatomical structures, image artifacts, image noise, spatial resolution, and overall diagnostic acceptability were evaluated at sixteen anatomical substructures using Likert-type scales. Results: Effective radiation dose (ED) was comparable between SECT and DECT study groups (2.9 ± 0.6 mSv/3.1 ± 0.7 mSv, p = 0.5). All examinations were rated as excellent or good for clinical diagnosis. Compared to the CNRD in the SECT group, the CNRD in the DECT group was significantly higher for the jugular veins relative to fatty tissue (7.51/6.08, p < 0.001) and for muscle tissue relative to fatty tissue (4.18/2.90, p < 0.001). The CNRD for the jugular veins relative to muscle tissue (3.33/3.18, p = 0.51) was comparable between groups. Image artifacts were less pronounced and overall diagnostic acceptability was higher in the DECT group (all p = 0.01). Conclusions: DECT weighted average images deliver higher objective and subjective image quality than SECT performed with TVA in head and neck imaging. Key Points: • Weighted average images derived from dual-energy CT deliver higher objective and subjective image quality than single-energy CT using automated tube voltage adaptation in head and neck imaging. • If available, dual-energy CT acquisition may be preferred over automated low tube voltage adopted single-energy CT for both malignant and non-malignant conditions.
CRIS-Team Scopus Importer:2022-04-29
Keywords: Automated tube voltage adaptation; Dual-energy computed tomography; Head and neck imaging; Weighted average dual-energy images

Image quality, diagnostic accuracy, and potential for radiation dose reduction in thoracoabdominal CT, using Sinogram Affirmed Iterative Reconstruction (SAFIRE) technique in a longitudinal study - Scharf, Michael; Brendel, Stephanie; Melzer, Katja; Hentschke, Christian; May, Matthias; Uder, Michael; Lell, Michael (PLoS ONE, 2017)
To step-wise evaluate image quality of sinogram-affirmed iterative reconstruction (SAFIRE) in reduced-dose (RD) thoracoabdominal computed tomography (CT) compared to full-dose (FD) and RD filtered back projection (FBP) in a longitudinal study.122 patients were included in this prospective study. 49 patients (14 men: mean age ± SD, 56±0.4 years; 35 women: 58±1.3 years) completed FD, RD1 (80%-dose) and RD2 (60%-dose) thoracoabdominal CT. Each CT dataset was reconstructed with FBP and SAFIRE. For quantitative image analysis image noise was measured in defined tissue regions. Qualitative image evaluation was performed according to the European Guidelines on Quality criteria for CT. Additionally artifacts, lesion conspicuity, and edge sharpness were assessed.Compared to FD-FBP noise in soft tissue increased by 12% in RD1-FBP and 27% in RD2-FBP reconstructions, whereas SAFIRE lead to a decrease of 28% (RD1) and 17% (RD2), respectively (all p <0.001). Visually sharp reproduction, lesion conspicuity, edge sharpness of pathologic findings, and overall image quality did not differ statistically significant between FD-FBP and RD-SAFIRE datasets. Image quality decreased in RD1- and RD2-FBP compared to FD-FBP, reaching statistically significance in RD2 datasets (p <0.001). In RD1- and RD2-FBP (p <0.001) streak artifacts were noted.Using SAFIRE the reference mAs in thoracoabdominal CT can be reduced by at least 30% in clinical routine without loss of image quality or diagnostic information.
EVALuna2:14645

Image quality of ultra-low radiation exposure coronary CT angiography with an effective dose <0.1 mSv using high-pitch spiral acquisition and raw data-based iterative reconstruction - Schuhbaeck, Annika; Achenbach, Stephan; Layritz, Christian; Eisentopf, Jasmin; Hecker, Franziska; Pflederer, Tobias; Gauss, Soeren; Rixe, Johannes; Kalender, Willi Alfred; Daniel, Werner; Lell, Michael; Ropers, Dieter (European Radiology, 2013)
Objectives: We evaluated the potential of prospectively ECG-triggered high-pitch spiral acquisition with low tube voltage and current in combination with iterative reconstruction to achieve coronary CT angiography with sufficient image quality at an effective dose below 0.1 mSv. Methods: Contrast-enhanced coronary dual source CT angiography (2 × 128 × 0.6 mm, 80 kV, 50 mAs) in prospectively ECG-triggered high-pitch spiral acquisition mode was performed in 21 consecutive individuals (body weight <100 kg, heart rate ≤60/min). Images were reconstructed with raw data-based filtered back projection (FBP) and iterative reconstruction (IR). Image quality was assessed on a 4-point scale (1 = no artefacts, 4 = unevaluable). Results: Mean effective dose was 0.06 ± 0.01 mSv. Image noise was significantly reduced in IR (128.9 ± 46.6 vs. 158.2 ± 44.7 HU). The mean image quality score was lower for IR (1.9 ± 1.1 vs. 2.2 ± 1.0, P < 0.0001). Of 292 coronary segments, 55 in FBP and 40 in IR (P = 0.12) were graded "unevaluable". In patients with a body weight ≤75 kg, both in FBP and in IR, the rates of fully evaluable segments were significantly higher in comparison to patients >75 kg. Conclusions: Coronary CT angiography with an estimated effective dose <0.1 mSv may provide sufficient image quality in selected patients through the combination of high-pitch spiral acquisition and raw data-based iterative reconstruction. Key Points: • Coronary CT angiography with an estimated effective dose <0.1 mSv is possible. • Combination of high-pitch spiral acquisition with iterative reconstruction achieves sufficient image quality. • Diagnostic accuracy remains to be assessed in future trials. © 2012 European Society of Radiology.
CRIS-Team Scopus Importer:2023-03-08
Keywords: Dual source CT; High-pitch spiral acquisition; Image quality; Iterative reconstruction; Ultra low-dose coronary CT angiography

Images Are Data: A Breast Imaging Perspective on a Contemporary Paradigm - Dietzel, Matthias; Clauser, Paola; Kapetas, Panagiotis; Schulz-Wendtland, Rüdiger; Baltzer, Pascal Andreas Thomas (Röfo-Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, 2021)
Background Considering radiological examinations not as mere images, but as a source of data, has become the key paradigm in the diagnostic imaging field. This change of perspective is particularly popular in breast imaging. It allows breast radiologists to apply algorithms derived from computer science, to realize innovative clinical applications, and to refine already established methods. In this context, the terminology imaging biomarker, radiomics, and artificial intelligence are of pivotal importance. These methods promise noninvasive, low-cost (e.g., in comparison to multigene arrays), and workflow-friendly (automated, only one examination, instantaneous results, etc.) delivery of clinically relevant information. Methods and Results This paper is designed as a narrative review on the previously mentioned paradigm. The focus is on key concepts in breast imaging and important buzzwords are explained. For all areas of breast imaging, exemplary studies and potential clinical use cases are discussed. Conclusion Considering radiological examination as a source of data may optimize patient management by guiding individualized breast cancer diagnosis and oncologic treatment in the age of precision medicine. Key Points: In conventional breast imaging, examinations are interpreted based on patterns perceivable by visual inspection. The radiomics paradigm treats breast images as a source of data, containing information beyond what is visible to our eyes. This results in radiomic signatures that may be considered as imaging biomarkers, as they provide diagnostic, predictive, and prognostic information. Radiomics derived imaging biomarkers may be used to individualize breast cancer treatment in the era of precision medicine. The concept and key research of radiomics in the field of breast imaging will be discussed in this narrative review. Citation Format Dietzel M, Clauser P, Kapetas P etal. Images Are Data: A Breast Imaging Perspective on a Contemporary Paradigm. Fortschr Röntgenstr 2021; DOI: 10.1055/a-1346-0095.
CRIS-Team Scopus Importer:2021-02-26
Keywords: artificial intelligence; breast; mammography; MR imaging; screening; ultrasound

Imaging atlas for eligibility and on-study safety of potential hip adverse events in anti-NGF studies (Part 2) - Roemer, Frank; Hayes, C. W.; Miller, C. G.; Hoover, K.; Guermazi, A. (Osteoarthritis and Cartilage, 2015)
Recently, nerve growth factor (NGF) inhibitors have been introduced for treatment of osteoarthritis (OA) symptoms, and have shown good analgesic efficacy and improvement in function in patients with OA. However, anti- (a-)NGF trials in OA had been suspended by the U.S. Food and Drug Administration (FDA) due to concerns over accelerated rates of OA progression and osteonecrosis. Since a-NGF therapies offer potential as the first new class of analgesics for many years, future studies assessing a-NGF compounds will have to follow stringent eligibility criteria and will require a rigorous safety monitoring. Imaging is paramount to identify potential negative outcomes as early as possible. These imaging findings include atrophic OA, osteonecrosis and others at eligibility and especially rapid progressive OA (RPOA) during the course of treatment. This second part of the a-NGF imaging atlas will present specific hip joint imaging findings that are relevant for eligibility and safety and represent potential adverse joint events on radiography and magnetic resonance imaging (MRI) in studies investigating a-NGF compounds. Researchers and clinicians should become familiar with several of these entities, and especially osteonecrosis of the hip and insufficiency fractures are relatively common findings in such a patient population. As several of these diagnoses may only be detected at late stages using radiographic methods, MRI plays an important role in identifying such pathologies early and at potentially still reversible stages before irreversible joint destruction has occurred.
EVALuna2:14549

Imaging atlas for eligibility and on-study safety of potential joint adverse events in anti-NGF studies - Roemer, Frank; Guermazi, Ali (Osteoarthritis and Cartilage, 2015)
EVALuna2:14544

Imaging atlas for eligibility and on-study safety of potential knee adverse events in anti-NGF studies (Part 1) - Roemer, Frank; Hayes, C. W.; Miller, C. G.; Hoover, K.; Guermazi, A. (Osteoarthritis and Cartilage, 2015)
Monoclonal antibodies that bind and inhibit nerve growth factor (NGF) have demonstrated both, good analgesic efficacy and improvement in function in patients with osteoarthritis (OA). Despite initial promising data, trials in OA had been suspended by the Federal Food and Drug Administration (FDA) due to concerns over accelerated rates of OA progression. Imaging will play a crucial role in future clinical trials to define eligibility of potential participants and to monitor safety during the course of these studies. This will require baseline and frequent follow-up radiographs of both, the index joints and other large weight bearing joints to identify subjects at risk prior inclusion and on study so treatment can be discontinued. This imaging overview in the form of an atlas describes and illustrates potential exclusionary joint imaging findings at eligibility and potential adverse joint events on radiography and magnetic resonance imaging (MRI) in studies investigating a-NGF compounds. The overarching goal of this atlas is to facilitate trial design and to promote a common language and understanding between potential expert readers. This first section of the atlas will focus on knee joint specific findings that are relevant to a-NGF studies.
EVALuna2:14552

Imaging atlas for eligibility and on-study safety of potential shoulder adverse events in anti-NGF studies (Part 3) - Roemer, Frank; Hayes, C. W.; Miller, C. G.; Hoover, K.; Guermazi, A. (Osteoarthritis and Cartilage, 2015)
Despite promising results, the U.S. Food and Drug Administration (FDA) put on hold trials assessing anti-nerve growth factor (a-NGF) compounds due to concerns over accelerated rates of OA progression. The mechanism of these events is unclear but joint adverse events were observed particularly in patients using a-NGFs in combination with non-steroidal anti-inflammatory drugs (NSAIDs), suggesting that the significantly greater analgesic effect of these separate classes of drugs prompted patients to permit increased joint load without experiencing the usual pain that would limit joint stress. Development of a-NGF drugs is continuing with stringent safety criteria included in future trials as a-NGF therapies offer potential as the first new class of analgesics in many years. Potential imaging joint safety findings and exclusionary criteria for eligibility for the large weight bearing joints were presented in parts I and II of this atlas. The shoulder as a non-weight bearing joint is likely to be less affected by increased loading due to efficacious pain reduction. However, it remains prone to degeneration especially due to concomitant rotator cuff pathology and previous trauma and inflammatory disorders. This third part of the atlas illustrates imaging findings relevant for eligibility and potential joint safety findings such as osteonecrosis, incidental findings such as large cystic lesions, inflammatory disorders, bone marrow disorders and metastases.
EVALuna2:14550

Imaging-detected acute muscle injuries in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games - Crema, Michel D.; Jarraya, Mohamed; Engebretsen, Lars; Roemer, Frank; Hayashi, Daichi; Domingues, Romulo; Skaf, Abdalla Y.; Guermazi, Ali (British Journal of Sports Medicine, 2018)
BACKGROUND: Acute muscle injuries in elite athletes are responsible for a large portion of time loss injuries. AIM: To describe the frequency, the anatomic distribution, and severity of imaging-detected acute muscle injuries among athletes who competed in the Rio de Janeiro 2016 Summer Olympics. METHODS: We recorded all sports injuries reported by the National Olympic Committee medical teams and the Organising Committee medical staff during the 2016 Summer Olympics. Imaging of acute muscle injuries was performed at the IOC's polyclinic within the Olympic Village using ultrasound and 3.0 T and 1.5 T MRI scanners. The assessment of images was performed centrally by three musculoskeletal radiologists. The distribution of injuries by anatomic location and sports discipline and the severity of injuries were recorded. RESULTS: In total, 11 274 athletes from 207 teams were included. A total of 1101 injuries were reported. Central review of radiological images revealed 81 acute muscle injuries in 77 athletes (66% male, mean age: 25.4 years, range 18-38 years). Athletics (track and field) athletes were the most commonly affected (n=39, 48%), followed by football players (n=9, 11%). The majority of injuries affected muscles from lower limbs (n=68, 84%), with the hamstring being the most commonly involved. Most injuries were grade 2 injuries according to the Peetrons classification (n=44, 54%), and we found 18 injuries exhibiting intramuscular tendon involvement on MRI. CONCLUSION: Imaging-detected acute muscle injuries during the 2016 Summer Olympics affected mainly thigh muscles in athletics disciplines.
EVALuna2:34714

Imaging following acute knee trauma - Kijowski, R.; Roemer, Frank; Englund, M.; Tiderius, C. J.; Sward, P.; Frobell, R. B. (Osteoarthritis and Cartilage, 2014)
Joint injury has been recognized as a potent risk factor for the onset of osteoarthritis. The vast majority of studies using imaging technology for longitudinal assessment of patients following joint injury have focused on the injured knee joint, specifically in patients with anterior cruciate ligament injury and meniscus tears where a high risk for rapid onset of post-traumatic osteoarthritis is well known. Although there are many imaging modalities under constant development, magnetic resonance (MR) imaging is the most important instrument for longitudinal monitoring after joint injury. MR imaging is sensitive for detecting early cartilage degeneration and can evaluate other joint structures including the menisci, bone marrow, tendons, and ligaments which can be sources of pain following acute injury. In this review, focusing on imaging following acute knee trauma, several studies were identified with promising short-term results of osseous and soft tissue changes after joint injury. However, studies connecting these promising short-term results to the development of osteoarthritis were limited which is likely due to the long follow-up periods needed to document the radiographic and clinical onset of the disease. Thus, it is recommended that additional high quality longitudinal studies with extended follow-up periods be performed to further investigate the long-term consequences of the early osseous and soft tissue changes identified on MR imaging after acute knee trauma.
EVALuna2:14553

Imaging for osteoarthritis - Hayashi, Daichi; Roemer, Frank; Guermazi, Ali (Annals of Physical and Rehabilitation Medicine, 2016)
Osteoarthritis (OA) is a widely prevalent disease worldwide and, with an increasing ageing society, is a challenge for the field of physical and rehabilitation medicine. Technologic advances and implementation of sophisticated post-processing instruments and analytic strategies have resulted in imaging playing a more and more important role in understanding the disease process of OA. Radiography is still the most commonly used imaging modality for establishing an imaging-based diagnosis of OA. The need for an effective non-surgical OA treatment is highly desired, but despite on-going research efforts no disease-modifying OA drugs have been discovered or approved to date. MR imaging-based studies have revealed some of the limitations of radiography. The ability of MR to image all relevant joint tissues within the knee and to visualize cartilage morphology and composition has resulted in MRI playing a key role in understanding the natural history of the disease and in the search for new therapies. Our review will focus on the roles and limitations of radiography and MRI with particular attention to knee OA. The use of other modalities (e.g. ultrasound, nuclear medicine, computed tomography (CT), and CT/MR arthrography) in clinical practice and OA research will also be briefly described. Ultrasound may be useful to evaluate synovial pathology in osteoarthritis, particularly in the hand.
EVALuna2:14688

Imaging Hepatocellular Carcinoma with Dynamic CT Before and After Transarterial Chemoembolization: Optimal Scan Timing of Arterial Phase - Saake, Marc; Lell, Michael; Eller, Achim; Wüst, Wolfgang; Heinz, Marco; Uder, Michael; Schmid, Axel (Academic Radiology, 2015)
The aim of this study was to determine the optimal arterial phase delay for computed tomography imaging of hepatocellular carcinoma (HCC) before and after transarterial chemoembolization (TACE) using a low iodine dose protocol.A total of 39 patients with known HCC were imaged with dynamic computed tomography of the liver (40-second scan duration, 60 mL of contrast medium), both on the same day before TACE and 1 day after TACE. Time attenuation curves of vessels, nonmalignant liver parenchyma, and 62 HCCs were normalized to a uniform aortic contrast arrival and analyzed.Maximal arterial phase HCC to liver contrast was reached between 13 and 17 seconds after aortic contrast arrival, both before and after TACE.Using our low iodine dose protocol, arterial phase imaging of HCC should be performed between 13 and 17 seconds after aortic contrast arrival, both before and after TACE.
EVALuna2:14493

Imaging in inflammatory arthritis: progress towards precision medicine - Minopoulou, Ioanna; Kleyer, Arnd; Yalcin-Mutlu, Melek; Fagni, Filippo; Kemenes, Stephan; Schmidkonz, Christian; Atzinger, Armin; Pachowsky, Milena; Engel, Klaus; Folle, Lukas; Roemer, Frank; Waldner, Maximilian; et al. (Nature Reviews Rheumatology, 2023)
Imaging techniques such as ultrasonography and MRI have gained ground in the diagnosis and management of inflammatory arthritis, as these imaging modalities allow a sensitive assessment of musculoskeletal inflammation and damage. However, these techniques cannot discriminate between disease subsets and are currently unable to deliver an accurate prediction of disease progression and therapeutic response in individual patients. This major shortcoming of today’s technology hinders a targeted and personalized patient management approach. Technological advances in the areas of high-resolution imaging (for example, high-resolution peripheral quantitative computed tomography and ultra-high field MRI), functional and molecular-based imaging (such as chemical exchange saturation transfer MRI, positron emission tomography, fluorescence optical imaging, optoacoustic imaging and contrast-enhanced ultrasonography) and artificial intelligence-based data analysis could help to tackle these challenges. These new imaging approaches offer detailed anatomical delineation and an in vivo and non-invasive evaluation of the immunometabolic status of inflammatory reactions, thereby facilitating an in-depth characterization of inflammation. By means of these developments, the aim of earlier diagnosis, enhanced monitoring and, ultimately, a personalized treatment strategy looms closer.
CRIS-Team Scopus Importer:2023-09-29

Imaging in Osteoarthritis - Hayashi, Daichi; Roemer, Frank; Jarraya, Mohamed; Guermazi, Ali (Radiologic Clinics of North America, 2017)
With technologic advances and the availability of sophisticated computer software and analytical strategies, imaging plays an increasingly important role in understanding the disease process of osteoarthritis (OA). Radiography has limitations in that it can visualize only limited features of OA, such as osteophytes and joint space narrowing, but remains the most commonly used modality for establishing an imaging-based diagnosis of OA. This article describes the roles and limitations of different imaging modalities and discusses the optimum imaging protocol, imaging diagnostic criteria of OA, differential diagnoses, and what the referring physician needs to know.
EVALuna2:14724